**5.3 Considerations of no clamp technique**


**273**

**6. Conclusions**

*Management of Ascending Aorta Calcification in Coronary Artery Bypass Grafting*

• As an original suture method, "no clamp" method has the advantages of both OPCABG and proximal anastomosis device. It requires no additional medical costs, not even tiny cost of urethra catheter. The operation process is simple, effective and accurate, with minimum risk of neurological complications from

• Compared with the water sac method, no clamp method avoids the possible risks associated with water sac. Direct suture is fast and effective. This technique is the alternative if the water sac technique is unavailable because of the

• For patients who fail to use Heartstring and Enclose, no clamp method could

• Both the piercing and perforating operation could damage or even cut off the suture, causing severe hemorrhage or suture failure. In this case, repeated

• This operation is also relatively time-consuming due to the secondary suture. Moreover, the piercing and perforating operation is under no cover of any inner aortic device, such as diaphragm umbrella of Enclose, spiral coil shape umbrella of Heartstring and water sac, which increases the possibility of bleed-

• Because the great saphenous vein is closed to the anastomotic position after the first suture and blood vortex exists during the secondary suture, a high accu-

The most common cause of stroke after OPCABG is the detachment of embolus,

When OPCABG is performed in patients with severe ascending aortic calcification, the above methods of proximal anastomosis are of practical and dissemination value. Based on decades of clinical experience, when encountering atherosclerotic plaque of ascending aorta, proximal anastomosis devices can be used to anastomose proximal aorta as priority, in order to maximally avoid the detachment of aortic atherosclerotic plaque or the damage of aortic dissection. When the proximal

• Surgeons should be properly trained before using no clamp method.

which is closely related to the progressive arteriosclerosis of ascending aorta. "No clamp" method is simple and effective, with minimum risk of the infarction induced by the detachment of atherosclerotic plaques through clamping operation.

racy of the suture is required to avoid thrombosis.

**5.5 Clinical significance of no clamp technology**

**5.4 Advantages and limitations of no clamp technology**

*DOI: http://dx.doi.org/10.5772/intechopen.91909*

clamping or intubating on the aorta.

severe uneven aortic inner wall.

be also considered as remedy.

*5.4.1 Advantages*

*5.4.2 Limitations*

suture is required.

ing and operative time.

**Figure 7.** *Puncture the artery wall and press it with fingers to stop bleeding.*

*Management of Ascending Aorta Calcification in Coronary Artery Bypass Grafting DOI: http://dx.doi.org/10.5772/intechopen.91909*
