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Ann Thorac Surg. 2018 Feb;105(2):645-649. doi: 10.1016/j.athoracsur.2017.07.054. Epub 2017 Nov 27.

Novel Automated Suturing Technology for Minimally Invasive Aortic Valve Replacements.

Author information

1
Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, New York. Electronic address: joshua_wong@urmc.rochester.edu.
2
Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, New York.
3
LSI SOLUTIONS, Victor, New York.

Abstract

PURPOSE:

Annular suture placement during minimally invasive right anterior thoracotomy aortic valve replacements (MI-AVR) can be challenging. We present the early clinical experience with novel automated suturing technology that may reduce the technical difficulty of this operation.

DESCRIPTION:

The technology presented involves an automated articulating suturing device that simultaneously drives dual-curved needles through the aortic annulus to place a pledgeted horizontal mattress suture remotely; a second device with 2 straight needles places suture through the sewing cuff of a prosthetic heart valve.

EVALUATION:

Automated annular suturing was used in five MI-AVR procedures, which were successfully completed, with no paravalvular leaks detected and a mean aortic valve gradient of 6.4 mm Hg postprocedure. Mean aortic cross-clamp and cardiopulmonary bypass times were 100 and 134 minutes, respectively. All 5 patients were successfully discharged home, with a mean intensive care unit and total length of stay of 2 and 7 days, respectively.

CONCLUSIONS:

Automated suturing during MI-AVRs is feasible and may reduce the technical challenge of this operation. Further research is necessary to determine its effect on patient outcomes.

[Indexed for MEDLINE]

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