Homograft With Bovine Pericardial Tube

This video demonstrates a technique of complex aortic reconstruction in bacterial endocarditis. The patient had a previous aortic valve replacement for native valve endocarditis, then a subsequent aortic root with a bio-Bentall procedure and hemiarch for recurrent bacterial endocarditis.
The patient presented years later with recurrent bacterial endocarditis with an aortic root abscess and valve vegetation. The procedure in the video highlights the use of a divided homograft: the distal aspect to replace the infected previous hemiarch graft, and the proximal homograft root to replace the infected bio-Bentall. To unite the two separated ends of the homograft, a handmade pericardial tube was created and utilized to replace the ascending aorta.