Bleeding may occur at the proximal anastomosis of an aortocoronary byp
ass graft due to the aortotomy being larger than the vein graft diamet
er. This results in the wall of the vein being under tension, so that
the anastomotic suture or further stitches may cut through. A partial
thickness suture placed as a pursestring around the aortotomy may alle
viate this situation, resulting in a smaller aortotomy with reduced ve
in wall tension, improved hemostasis, and a more satisfactory anastomo
tic vein contour.