초록접수 현황
| 20F-038 | 구연 발표 |
The feasibility of Cor-knot automated fastener in minimally invasive aortic valve replacement
Chang Hun Kim, Chee-Hoon Lee, Hyung Gon Je, Min Ho Ju, Mi Hee Lim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital (PNUYH), Medical Research Institute of Pusan National University, Yangsan-si, South Korea
Purpose : The use of Cor-knot automated fastener may be more useful in the setting of minimally invasive cardiac surgery (MICS) which performed through limited surgical field than in conventional sternotomy setting. We sought to compare the perioperative outcomes of aortic valve replacement (AVR) via right anterior thoracotomy (RAT) using Cor-knot (CK) automated fastener or manual tie (MT).
Methods : From April 2011 to July 2020, consecutive 216 patients underwent AVR via RAT. Among them, the patients who needed conversion to median sternotomy (n=2) or AVR with rapid deployment or sutureless valve (n=44) were excluded. Finally, 170 patients were enrolled, and their perioperative clinical outcomes and hemodynamic profiles were evaluated.
Results : Among 170 patients, CK and MT was used in 46 (27.1%) and 124 (72.9%), respectively. There were no significant differences in baseline characteristics, early clinical outcomes and early adverse outcomes in the two groups. Cardiopulmonary bypass and cardiac ischemic times were significantly shorter in the CK group than MT group (96.1 ± 18.6 minutes vs. 120.0 ± 34.5 minutes, P<0.001, and 71.2 ± 15.8 minutes vs. 88.8 ± 25.6 minutes, P<0.001). There were no inter-group differences in immediate postoperative hemodynamic profiles including mean pressure gradient of aortic valve (13.4 ± 6.3 mmHg in CK group vs. 14.5 ± 7.2 mmHg in MT group, P = 0.386) and para-valvular leakage of grade II or higher (0/46 [0.0%] vs. 2/124 [1.6%], P = 0.498).
Conclusion : The use of Cor-knot in RAT AVR is associated with shorter cardiac procedural time with comparable safety compared to manual tie.
Methods : From April 2011 to July 2020, consecutive 216 patients underwent AVR via RAT. Among them, the patients who needed conversion to median sternotomy (n=2) or AVR with rapid deployment or sutureless valve (n=44) were excluded. Finally, 170 patients were enrolled, and their perioperative clinical outcomes and hemodynamic profiles were evaluated.
Results : Among 170 patients, CK and MT was used in 46 (27.1%) and 124 (72.9%), respectively. There were no significant differences in baseline characteristics, early clinical outcomes and early adverse outcomes in the two groups. Cardiopulmonary bypass and cardiac ischemic times were significantly shorter in the CK group than MT group (96.1 ± 18.6 minutes vs. 120.0 ± 34.5 minutes, P<0.001, and 71.2 ± 15.8 minutes vs. 88.8 ± 25.6 minutes, P<0.001). There were no inter-group differences in immediate postoperative hemodynamic profiles including mean pressure gradient of aortic valve (13.4 ± 6.3 mmHg in CK group vs. 14.5 ± 7.2 mmHg in MT group, P = 0.386) and para-valvular leakage of grade II or higher (0/46 [0.0%] vs. 2/124 [1.6%], P = 0.498).
Conclusion : The use of Cor-knot in RAT AVR is associated with shorter cardiac procedural time with comparable safety compared to manual tie.
첨부파일 : box plot_ppt.pptx
책임저자: Chee-Hoon Lee
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital (PNUYH), Medical Research Institute of Pusan National University, Yangsan-si, South Korea
발표자: Chang Hun Kim, E-mail : chk0023@gmail.com