Abstract
BackgroundCORKNOT® facilitates a reduction in cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and operative time, but reported to be associated with other complications. We aim to quantify the incidence of valvular complications related to CORKNOT® and determine the feasibility of its use between different valvular surgeries.MethodsPatients who underwent heart valve repair or replacement surgery via the use of automated titanium suture fasteners (CORKNOT®) in a tertiary care hospital were included in the study. This single-centre retrospective study was conducted on 132 patients between January 2016 and June 2018.ResultsIn our study, the overall mean operative time was 320.0 ± 97.0 min, mean CPB time was 171.4 ± 76.0 min and the calculated mean ACC time was 105.9 ± 54.0 min. Fifty-eight patients (43.9%) underwent minimally invasive valve replacement or repair surgery and 66 patients (50.0%) underwent concomitant procedures. A total of 157 valves were operated on, with 112 (84.8%) single valve surgeries, 15 (11.4%) double valve surgeries and 5 (3.8%) triple valve surgeries. After reviewed by the cardiologist blinded towards the study, we report trivial and/or mild paravalvular leak (PVL) in immediate post-operative echocardiography was found in 1 (1.01%) patients. There were no reported cases of valvular thrombosis, leaflet perforation, device dislodgement or embolization, moderate and/or severe PVL during hospitalization and follow-up echocardiography within 1 year. Single mitral valve and aortic surgeries had comparable incidences of post surgical complications.ConclusionWe conclude the feasibility of CORKNOT® utilisation in mitral and aortic valve surgeries. Additionally, incidence of CORKNOT® related complications in heart valve repair or replacement surgery is less usual in our setting than previously reported. These results motivate the use of CORKNOT® as a valid alternative with complete commitment.
Highlights
The CORKNOT® device is an automated titanium suture fastening system used predominantly in minimally invasive cardiac surgery
CORKNOT® was shown to be consistently better compared to hand-tied knot, resulting in a reduction in cardiopulmonary bypass time, aortic cross clamp time and operative time reported in minimally invasive mitral valve repair and aortic valve replacement [3]
The final study population consisted of 132 patients who underwent heart valve replacement and/or repair procedures using CORKNOT®
Summary
The CORKNOT® device is an automated titanium suture fastening system used predominantly in minimally invasive cardiac surgery. It is an ergonomic device that allows automatic crimping and trimming of sutures with a single squeeze. It enables suture orientation away from the valvular leaflets while allowing simultaneous suture tensioning and prosthetic cuff compression for suture security. CORKNOT® was shown to be consistently better compared to hand-tied knot, resulting in a reduction in cardiopulmonary bypass time, aortic cross clamp time and operative time reported in minimally invasive mitral valve repair and aortic valve replacement [3]. CORKNOT® facilitates a reduction in cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and operative time, but reported to be associated with other complications. We aim to quantify the incidence of valvular complications related to CORKNOT® and determine the feasibility of its use between different valvular surgeries
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