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. 2013 Sep 4;8:188. doi: 10.1186/1749-8090-8-188

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Copyright © 2013 Brechtel et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Surgical dissection, Y-graft placement and positioning. Surgical procedure: after redo sternotomy, the ascending aorta and the aortic arch with its branches are dissected (a). As proximal as possible, a Y-shaped prostheses is anastomosed end-to-side at the ascending aorta prostheses (b). Distal anastomoses to the brachiocephalic trunk (end-to-side), the left carotid artery (side-to-side) and the left subclavian artery (end-to-side) (c; patient #2). Cartoon showing the surgical anastomosis to the aortic prosthesis (d); 1: Aortic Prosthesis from previous surgery, 2: New, secondary aortic pathology (i.e. aneurysm, re-dissection), 3: Y-graft, 4: Stentgraft.