Page 1 :
BENTALL AND MINI BENTALL PROCEDURE PART 3…, The French Cuff technique…, In cases where bio root is required (using a tissue, valve and decron graft) the French Cuff technique, is favoured to improve haemostasis., With the annulus prepared, pledgeted 2-0, ethibond excel annulus horizontal mattress sutures, are placed in inferior surface of the aortic annulus.

Page 2 :
Above diagram shows placement of pledgeted 2-0, ethibond sutures on the inferior surface of aortic, annulus., To apply for the French Cuff technique, the tube, graft selected should be 5 mm greater in diameter, than valve size., Coronary button re implantation.., After marking the coronary buttons portion on the, graft, the heart is offloaded., The opthalmic cautery is used to create holes on, the graft., The buttons are then sewn onto the graft using full, thickness bites of continuous 5-0 polypropylene, suture.

Page 3 :
An aortic root vent is inserted prior to tying the, suture end., , Reimplantation of the left coronary buttons onto, the tube graft using a continuous 5-0, polypropylene suture.

Page 4 :
Distal Anastomosis, The graft is appropriately opposed to the distal, aorta and a continuous 3-0 polypropylene suture, used starting on the posterior wall at 4 o clock, position.

Page 5 :
Placement of continuous 3-0 polypropylene suture, to anastomose graft and distal aorta., , Hemi arch replacement, When distal ascending aorta pathology exist, hemi, arch replacement is required., In this case, the patient will require systemic, cooling to 25 degree centigrade and Selective, cerebral perfusion for the open distal anastomosis., , The End......