Figure 4. Post-bypass gross photograph of the heart and ascending aorta. The aortic root was reconstructed using a valve-sparing technique. The right atrium (star) was used for central venous cannulation and later secured with a blue tourniquet. The arterial cannula has been removed and hemostasis achieved using a pledgeted purse string suture on the lateral side of the aortic graft (triangle). The right coronary artery demonstrates periarterial hematoma (arrow) from the proximal dissection, which was bypassed with a vein graft (circle). A blue vessel loop is retracting the innominate vein to better expose the innominate artery, which was reimplanted.