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Thu Aug 23 04:41:51 BST 2007

I would have waited to do the surgery, but when I did, I would have made a  
limited median sternotomy only to the base of neck, enough to sew a 14 or 16 mm 
 bifurcated HEMOSHIELD type graft to the ascending aorta, just preparatory 
and  ready.     I would then extend the incision up the neck, and  probably 
divided the innominate vein.   If I thought I could quickly  and without 
narrowing, do a primary lateral repair, I would have done that. and  then just 
oversewed the base of my previously placed Dacron graft.    Otherwise I would have 
first done an end to end to the left carotid and then  separately to the distal 
innominate.      

k

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