STEP 4Suture on the caval side

A ring reinforced polytetrafluoroethylene (PTFE) 10-mm graft is cut in tangential fashion in order to obtain a 12 - to 14-mm opening for anastomosis. If the decision to place a wider graft has been made, a wider venotomy must be performed.

Using a 5-0 vascular Prolene suture placed at each angle, the graft is sewn with a running suture (Figure 4). The suture is placed from outside. An everted suture is advised at this point in order to minimize exposure of rough areas in the vascular lumen.

When the suture is completed, the graft is filled with heparinized saline.

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How to Stay Young

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