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Modified Yasui Operation Using Cryopreserved Femoral Vein Homograft.

Research paper by Manan H MH Desai, Pranava P Sinha, Richard A RA Jonas, Karthik K Ramakrishnan

Indexed on: 25 Mar '20Published on: 25 Mar '20Published in: The Annals of Thoracic Surgery



Abstract

The Yasui operation is indicated in interrupted aortic arch and a posterior mal-aligned ventricular septal defect with a narrow subaortic region. We present a modification of the Yasui procedure in which the aortic reconstruction was simplified using a non-valved cryopreserved femoral vein homograft to connect the pulmonary artery to the descending aorta. A side-to-side anastomosis was performed between the femoral vein homograft and ascending aorta to complete neo-aortic reconstruction. After baffling the left ventricle to the pulmonary artery with a patch, a valved segment from the same femoral vein homograft was used to restore continuity of the right ventricular outflow. Yasui et al first described the eponymous technique of repair of interrupted aortic arch (IAA) and severe left ventricular outflow tract obstruction (LVOTO). The essential elements of this operation are aortic arch augmentation, creation of a proximal aortopulmonary connection (Damus-Kaye-Stansel anastomoses), baffling the left ventricle to the aortic and pulmonary valve across the ventricular septal defect (VSD) and finally restoring right ventricle to pulmonary artery continuity with a conduit. We describe a modification of the original Yasui operation using cryopreserved femoral vein homograft. Copyright © 2020. Published by Elsevier Inc.