Bilateral internal mammary artery grafting is associated with improved long-term patient outcomes. In situ right internal mammary artery grafting of the obtuse marginal artery, through the transverse sinus, is often limited by conduit length. We describe

In patients without aortic arch calcification, elective total ascending aorta replacement can be performed without circulatory arrest, by positioning obliquely a clamp from the brachiocephalic trunk, which is partially clamped, to the distal aortic arch. This technique was used in 8 consecutive patients in the first 3 months of 2002. None of them experienced any complication.