Feasibility of Robotic Mitral Valve Repair Using Barbed Nonabsorbable Sutures: A Preliminary Single-Center Experience.

Autor:	Round KJ; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Yost CC; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Rosen JL; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Haenen FWN; Department of Cardiac Surgery, Antwerp University Hospital, Edegem, Belgium., Komlo CM; Section of Cardiothoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Wong DH; Department of Surgery, Division of Cardiac Surgery, University of Virginia, Charlottesville, VA, USA., Mandel JL; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Prochno KW; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Ott NY; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Guy TS; Division of Cardiac Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Jazyk:	angličtina
Zdroj:	Innovations (Philadelphia, Pa.) [Innovations (Phila)] 2023 May-Jun; Vol. 18 (3), pp. 254-261. Date of Electronic Publication: 2023 May 25.
DOI:	10.1177/15569845231174228
Abstrakt:	Objective: Barbed nonabsorbable sutures have been widely adopted for tissue closure in noncardiac robotic surgery to improve intraoperative efficiency. Here, we examine the profile in robotic mitral valve repair (rMVR), which utilized barbed nonabsorbable sutures. To our knowledge, this is the first report to describe clinical outcomes for rMVR with barbed nonabsorbable sutures. Methods: A retrospective review identified 90 patients who underwent rMVR using barbed nonabsorbable sutures at our center between 2019 and 2021. The primary outcome measure was dehiscence, while other relevant outcomes included 30-day readmission and 30-day mortality. Results: In addition to fixation of the mitral annuloplasty band, barbed nonabsorbable sutures were employed commonly in concomitant pericardiectomy closure (100.0%, 90 of 90), atriotomy closure (100.0%, 90 of 90), and left atrial appendage closure (if eligible; 98.8%, 83 of 84). One patient who underwent mitral valve annuloplasty using only barbed nonabsorbable suture required reoperation for annuloplasty ring dehiscence. Immediate postoperative ring dehiscence was not observed in any patients after the routine reinforcement of barbed nonabsorbable sutures with everting pledgeted polyester sutures, and no additional patients required reoperation for suture-related complications. Clinical signs of dehiscence were not observed after pericardiectomy, atriotomy, or left atrial appendage closure with barbed nonabsorbable sutures. The 30-day readmission rate was 3.3% (3 of 90), and 30-day mortality was 0% (0 of 90). Conclusions: These data suggest the initial feasibility of barbed nonabsorbable sutures in robotic cardiac surgery, specifically within rMVR. Further research is necessary to explore the long-term safety and efficacy profile of such approach.
Databáze:	MEDLINE
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