Mini-Bentall Procedure: The “French Cuff” Technique

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Mini-Bentall Procedure: The “French Cuff” Technique Tristan D. Yan, MD, PhD The Annals of Thoracic Surgery Volume 101, Issue 2, Pages 780-782 (February 2016) DOI: 10.1016/j.athoracsur.2015.06.092 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The needles of the annular sutures are driven through the aortic annulus from the ventricular side to the aortic side, by using a horizontal mattress technique. The Annals of Thoracic Surgery 2016 101, 780-782DOI: (10.1016/j.athoracsur.2015.06.092) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The proximal cuff of the Valsalva graft (Vascutek Ltd, Renfrewshire, Scotland) is trimmed down to 8 mm. This cuff is folded back over the outside of Valsalva portion of the graft to make a double cuff, hence the name “French Cuff” technique. The Annals of Thoracic Surgery 2016 101, 780-782DOI: (10.1016/j.athoracsur.2015.06.092) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A prosthetic valve is positioned inside the Valsalva graft (Vascutek Ltd, Renfrewshire, Scotland). The annular sutures are passed through the sewing ring of the prosthesis first and then through the folded proximal edge of the Valsalva graft. The Annals of Thoracic Surgery 2016 101, 780-782DOI: (10.1016/j.athoracsur.2015.06.092) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 The annular sutures are tied and cut one by one to ensure that the prosthesis is seated properly in the supraannular position. The Annals of Thoracic Surgery 2016 101, 780-782DOI: (10.1016/j.athoracsur.2015.06.092) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 The second “hemostatic” layer is performed using a 4-0 running polypropylene suture, to incorporate the remnant of aortic wall and the everted cuff edge. The Annals of Thoracic Surgery 2016 101, 780-782DOI: (10.1016/j.athoracsur.2015.06.092) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions