In my quest to facilitate and simplify minimally invasive, right mini-thoracotomy aortic valve surgery over the past 11 years, I have tried many different techniques and devices.
I believe that the aortic cuff (Miami Instruments, Miami, FL) significantly facilitates and improves the exposure necessary to perform an expeditious and safe operation.
I am constantly asked how is it that I insert the aortic cuff. Due to this, I have decided to make a short You tube video. This is the current and most effective way to insert the cuff.
Of note, patients that have a heavily calcified aortic root may not be good candidates for insertion of the cuff. The cuff needs a semi compliant aorta in order for it to expand inside the root.
There may also be difficulty with insertion of the cuff in patients with a bicuspid aortic valve. In these patients, with fusion of the left and right cusps, I will place the cuff through the commissural stay suture between the left and right cusp. (Normally it will be placed through the suture between that left and non-coronary cusps). This is not always perfect but does help. If the cuff slips in these cases, I will remove it.
There are also a small group of patients who can have the procedure performed without a cuff because visibility is adequate.
Insertion of Aortic Cuff (you can click this link or copy and paste the link below)