M. Morgant, G. Malapert, A. Petrosyan, Charline Pujos, S. Jazayeri, O. Bouchot
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Statistical analyses were done using a propensity score with 1:1 matching for the automatically tied (AT) and manually tied (MT) patients.\n\n\nRESULTS\nThe aortic cross-clamping and cardiopulmonary bypass times were significantly decreased in the AT group (74 ± 13.8 minutes vs 90.4 ± 23.7 minutes, p<0.0001, and 100.8 ± 20.6 minutes vs 117.6 ± 33.1 minutes, p<0.0001), compared with the MT group. Clinical outcomes were similar in the two groups, whether in the analysis of non-matched or matched groups. There was no difference in 30 day-mortality (1.2% vs 0%, p=0.37), and the stroke and transient ischemic attack rates were comparable (2.5% vs 1.6%; p=0.67). There was no significant increase in pacemaker implantation in the AT group (1.3% vs 0%, p=0.36), and the rate of aortic regurgitation ≥ 2 was lower (3.9% vs 0%; p=0.11) but not statistically significant.\n\n\nCONCLUSIONS\nThe automated Cor-Knot fastener is an easy-to-use, time-saving device which does not increase perioperative morbidity and mortality in patients undergoing aortic valve replacement by right anterior minithoracotomy.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"10","resultStr":"{\"title\":\"Comparison of automated fastener device Cor-Knot versus manually tied knot in minimally-invasive isolated aortic valve replacement surgery.\",\"authors\":\"M. Morgant, G. Malapert, A. Petrosyan, Charline Pujos, S. Jazayeri, O. 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引用次数: 10
摘要
本前瞻性研究的目的是评估Cor-Knot装置在右前小开胸术中孤立主动脉瓣置换术的有效性和安全性。方法2009年9月至2018年6月进行单中心前瞻性研究。对440例患者行右前小开胸主动脉瓣置换术。在这些患者中,221人接受了支架假体的孤立AVR手术。63例(28.5%)患者使用Cor-Knot钛扣固定缝线,158例(71.5%)患者使用手打结。采用1:1匹配的倾向评分对自动捆绑(AT)和手动捆绑(MT)患者进行统计分析。结果与MT组相比,AT组主动脉交叉夹闭和体外循环次数(74±13.8 min vs 90.4±23.7 min, p<0.0001)和(100.8±20.6 min vs 117.6±33.1 min, p<0.0001)显著减少。无论是在非匹配组还是匹配组的分析中,两组的临床结果相似。30天死亡率无差异(1.2% vs 0%, p=0.37),卒中和短暂性脑缺血发作率相当(2.5% vs 1.6%;p = 0.67)。AT组起搏器植入率无显著增加(1.3% vs 0%, p=0.36),≥2级主动脉瓣返流率较低(3.9% vs 0%;P =0.11),但无统计学意义。结论自动corknot扣箍是一种使用简单、省时的装置,不会增加右前小胸切开主动脉瓣置换术患者围手术期的发病率和死亡率。
Comparison of automated fastener device Cor-Knot versus manually tied knot in minimally-invasive isolated aortic valve replacement surgery.
BACKGROUND
The aim of our prospective study was to evaluate the efficacy and the safety of the Cor-Knot device in isolated aortic valve replacement by right anterior minithoracotomy.
METHODS
A single-center, prospective study was conducted between September 2009 and June 2018. Four hundred and forty patients were operated on for aortic valve replacement by right anterior minithoracotomy. Of these patients, 221 underwent isolated AVR surgery with stented prosthesis. Sutures were secured using the Cor-Knot titanium fastener in 63 patients (28.5%) and knots were hand-tied in 158 (71.5%). Statistical analyses were done using a propensity score with 1:1 matching for the automatically tied (AT) and manually tied (MT) patients.
RESULTS
The aortic cross-clamping and cardiopulmonary bypass times were significantly decreased in the AT group (74 ± 13.8 minutes vs 90.4 ± 23.7 minutes, p<0.0001, and 100.8 ± 20.6 minutes vs 117.6 ± 33.1 minutes, p<0.0001), compared with the MT group. Clinical outcomes were similar in the two groups, whether in the analysis of non-matched or matched groups. There was no difference in 30 day-mortality (1.2% vs 0%, p=0.37), and the stroke and transient ischemic attack rates were comparable (2.5% vs 1.6%; p=0.67). There was no significant increase in pacemaker implantation in the AT group (1.3% vs 0%, p=0.36), and the rate of aortic regurgitation ≥ 2 was lower (3.9% vs 0%; p=0.11) but not statistically significant.
CONCLUSIONS
The automated Cor-Knot fastener is an easy-to-use, time-saving device which does not increase perioperative morbidity and mortality in patients undergoing aortic valve replacement by right anterior minithoracotomy.