A new method for graft tailoring in hemiarch replacement

We describe a method of graft tailoring in hemiarch replacement that can accommodate long elliptical distal anastomosis and the right angle between the arch and ascending aorta without kinks, resulting in a more physiologic shape of the neoaorta. The distal end of the graft is beveled superiorly, to spare the origins of brachiocephalic vessels as in the standard bevel technique, but the incision line is curvilinear to form a concave cut end. Once the distal anastomosis is completed and the concavity of the cut end is straightened, the undersurface of the graft tongue forms a lesser curvature of the arch.