Faizus Sazzad1,2,3, Ong Zhi Xian1,2, Ashlynn Ler1,4, Chang Guohao2,5, Kang Giap Swee2,5, Theo Kofidis6,7,8,9. 1. Cardiac Surgery Experimental Laboratory, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 2. Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, 1E Kent Ridge Road, Singapore, 119228, Singapore. 3. Cardiovascular Research Institute, National University of Singapore, Singapore, Singapore. 4. School of Medicine, National University of Ireland, Galway, Ireland. 5. National University Hospital, National University Health System, Singapore, Singapore. 6. Cardiac Surgery Experimental Laboratory, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. tkofidis@yahoo.com. 7. Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, 1E Kent Ridge Road, Singapore, 119228, Singapore. tkofidis@yahoo.com. 8. Cardiovascular Research Institute, National University of Singapore, Singapore, Singapore. tkofidis@yahoo.com. 9. National University Hospital, National University Health System, Singapore, Singapore. tkofidis@yahoo.com.
Abstract
BACKGROUND: 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. METHODS: Patients 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. RESULTS: In 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. CONCLUSION: We 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.
BACKGROUND: 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. METHODS:Patients 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. RESULTS: In 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. CONCLUSION: We 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.
Authors: G Perin; M Shaw; V Pingle; K Palmer; O Al-Rawi; T Ridgway; D Pousios; P Modi Journal: Ann R Coll Surg Engl Date: 2019-06-03 Impact factor: 1.891
Authors: Tyler J Beute; Matthew D Oram; Timothy M Schiller; Matthew Goehler; Jessica Parker; Charles L Willekes; Tomasz Timek Journal: Ann Thorac Surg Date: 2018-03-01 Impact factor: 4.330
Authors: Maciej Haberka; Magdalena Malczewska; Piotr Pysz; Michał Kozłowski; Wojciech Wojakowski; Grzegorz Smolka Journal: J Cardiovasc Magn Reson Date: 2021-03-22 Impact factor: 5.364
Authors: Martin T R Grapow; Miroslawa Mytsyk; Jens Fassl; Patrick Etter; Peter Matt; Friedrich S Eckstein; Oliver T Reuthebuch Journal: J Cardiothorac Surg Date: 2015-11-03 Impact factor: 1.637