"Double Cuff" Technique for Modified Bentall Procedure

The combination of interrupted and running sutures was initially introduced as a tandem suture line to improve haemostasis in the modified Bentall procedure. These techniques basically consist of two suturing techniques. This paper reports the "Double Cuff" technique, which uses only one interrupted suture with a double-folded layer between the aortic remnant wall of Valsalva and the aortic ring and a double-folded layer on the composite graft side to ensure absolute proximal annular haemostasis. The proximal side of the composite graft is made by fashioning a double layer, in which the graft is everted inside and sutured with the prosthetic valve. The "Double Cuff" technique is a simple, reproducible and durable method for ensuring haemostasis and should be considered as a supplementary procedure for proximal anastomosis.