Application of a clampless hemostatic device (HeartString®) for outflow graft anastomosis.

Performing an aortic anastomosis with a prosthetic graft (e.g. for left ventricular assist device implantation or veno-arterial extracorporeal membrane oxygenation) requires side-clamping of the aorta. Clamping of aorta is particularly challenging in redo cases and/or in patients with a short ascending aorta and open coronary artery bypass grafts, or atherosclerotic disease of the aorta. In this video tutorial, we provide a thorough description of the surgical technique for applying the HeartString® Proximal Seal System (MAQUET Holding B.V. & Co. KG, Rastatt, Germany) for the anastomosis of the aorta with a prosthesis graft. The feasibility of using the HeartString® device has been demonstrated and no procedure-related complications were experienced.