Continous lines show threads on the external surface of the aorta. Dotted lines show the internal passages of the needle as well the threads inside the aorta. a) In contrast to the previous technique the passages of the needle are oblique to the ascending aorta and made in the opposite direction. The X of the threads is inside the aorta and it covers the hole from the bottom. b) In the second stitch the 2 passages of the needle are the same as in the first but the whole second stitch acts in the opposite direction to the first. c) a square of the threads is completed outside the aorta around the hole. Each stitch is tied with half of the tension required in the previous technique. The aorta is not deformed. Supplemental stitches and teflon-felt pledgets are not necessary.