| Popis: |
Background: Barbed sutures have rarely been used in cardiac surgery. The reason is the absence of safety and feasibility data. This study was set up to assess the safety and efficacy using barbed sutures for right atrium cannulation-site closure both in short and longer-term follow up. Methods: Ten patients undergoing routine CABG through sternotomy with the use of ECC were included after giving written informed consent. After performing CABG, closure of the venous cannulation site at the right atrium is performed, using Stratafix® 2/0 non-resorbable, spiral polypropylene (SXPL1B400), without knotting. Results: No postoperative bleeding complications or revisions for bleeding or tamponade were noted. No complications or major adverse cardio-cerebrovascular incidents were registered during follow-up. The relevance of this lies in the difficulty in tying timely knots, even in experienced hands, during scopic or minimally invasive procedures. Being able to avoid this cumbersome procedure would largely reduce time spent on tying knots (the single most efficient time reducing step in minimally invasive cardiac surgery). Conclusion: Using knotless barbed sutures with an additional self-locking manoeuvre is feasible for the closure of the right atrium cannulation site in cardiac surgery, with no short-term or long-term complications. This opens up possibilities using knotless barbed sutures safer in minimally invasive cardiac surgery. This study confirms barbed knotless sutures perform adequately when closing a low-pressure cardiac structure, and in such, potentially saving time in minimally invasive surgery. Further investigation in closure of other cardiovascular structures is advisable and are planned by the authors. |
