The muscle cuff of the DAHs was reinforced with a strip of autologous pericardium and proximal anastomosis was performed using either interrupted 4-0 polypropylene sutures or three running sutures between two commissures. The coronary buttons were anastomosed using continuous 6-0 polypropylene sutures. A running 4-0 polypropylene suture was used for distal anastomosis. At the end of the operation, transoesophageal echocardiography was routinely performed to evaluate DAH function. In paediatric patients, aspirin was administered 3–6 months, and in adult patients warfarin was recommended for 2 months followed by continued aspirin medication.