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Journal of Cardiovascular Medicine and Surgery 12(1):p 07-10, Jan-April 2026. | DOI: DOP : 10.21088/jcms.2454.7123.12126.1
Review Article
Aortotomy Closure after Cardiac Valve Replacements: Nightmare for Surgeons
Dharmendra Kumar Srivastava, Navneet Srivastava, A.P. Jain, S.S. Rajput
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Journal of Cardiovascular Medicine and Surgery 12(1):p 07-10, Jan-April 2026. | DOI: DOP : 10.21088/jcms.2454.7123.12126.1
How Cite This Article:
Dharmendra Kumar Srivastava, Navneet Srivastava, A.P. Jain, et al. Aortotomy Closure after Cardiac Valve Replacements: Nightmare for Surgeons. Indian J Cardiovasc Med Surg. 2026; 12(1): 07–10Timeline
Received : January 16, 2026
Accepted : February 20, 2026
Published : April 30, 2026
Abstract
After performing an aortotomy, a variety of techniques can be utilized for suture closure. However, there is no published data comparing the efficacy of different suture techniques. The goal of this study is to ensure a tight seal of the aortotomy closure. This study was carried out prospectively from February 2021 to December 2022 and follow up continued till October 2025 at the Dr. RML Institute of Medical Sciences. We included patients undergoing aortic valve replacement as well as combined aortic and mitral valve replacements. Our technique for transverse/ oblique aortotomy closure uses 4/0 polypropylene suture, passed from the outside through the lower edge and emerging from the upper margin, repeated in sequence, with the sutures tied externally. In our study of 107 cases, aortic valve replacement was performed in 33.64% of patients, while 66.35% underwent combined aortic and mitral valve replacement. Patients included both genders, with ages ranging from 24 to 70 years. No bioglue or hemostatic gels were used, and sternum re-exploration was required in only 0.93% of cases. A simple, low cost but novel technique that ensures a tight seal of the aortotomy edges is to close the first layer with horizontal mattress sutures and the second layer with an over and-over suture, even in cases of a dilated, thin-walled aorta.
References
- 1. J. Bhaskar, A.K. Sharma: Simple and Secure Aortotomy Closure. Asian Cardiovascular and Thoracic Annals Volume 15, Issue 2 April 2007.
- 2. Tsuji H.K., Redington J.V., Kay J.H. Aortotomy closure. Ann Thorac Surg 1967; 3: 172.
- 3. Daniel D. Holloway, Jehangir J. Appoo. An ex-vivo quantitative assessment to determine the optimal aortotomy closure technique J Cardiothorac Surg. 2015 Sep 9; 10: 114. doi: 10.1186/s13019-015-0325-7
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
The authors report no conflicts of interest in this work.
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Cite this article
Dharmendra Kumar Srivastava, Navneet Srivastava, A.P. Jain, et al. Aortotomy Closure after Cardiac Valve Replacements: Nightmare for Surgeons. Indian J Cardiovasc Med Surg. 2026; 12(1): 07–10
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| January 16, 2026 | February 20, 2026 | April 30, 2026 |
DOI: DOP : 10.21088/jcms.2454.7123.12126.1
Keywords
AortotomySutureSealLeakageSearch for Similar Articles
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Timeline
| Received | January 16, 2026 |
| Accepted | February 20, 2026 |
| Published | April 30, 2026 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
