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Outcome of Semicontinuous, Non Pledgetted Mono Filament Suture Technique for Aortic Valve Replacement

Manish Pangi, Associate Professor, Department of Cardiac Surgery, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bengaluru, Karnataka 560069, India , Satish Govindaiah , Vivekananda Siddiah , Manish Pangi , Sudheer Lakshman ,

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Journal of Cardiovascular Medicine and Surgery 4(2):p 159-164, April-June 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.15

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Abstract

Context: The semi continuous monofilament suturing technique has been proposed as a viable alternative to interrupted pledgetted technique for aortic valve replacement. It is a quick, simple technique and may reduce prosthetic material exposure.

Aims: To compare outcome of semi continuous versus interrupted pledgetted suturing techniques for aortic valve replacement.

Settings and Design: Prospective study to compare suturing techniques for aortic valve replacement in our institution.

Methods and Material: 330 patients who underwent isolated aortic valve replacement were included of which 220 patients underwent interrupted (group I) and 110 (group II) semicontinuous technique. Patient characteristics, operative
and early post operative data were compared.

Statistical analysis used: Baseline characteristics were compared using Z test. Student’s t test was used to compare operative data and complication rates. A p value of <0.005 was considered significant.

Results: Analysis showed that the CPB and cross clamp time was significantly shorter and valve size used was atleast one size larger in the semicontinuous group. Valve thrombosis was seen in 3 patients in group I and no patient in group II. They were managed conservatively. Paravalvular leak was seen in 2 patients in group II. Both the patients had native annulus >25mm and regurgitation type with minimal fibrosis of the annulus. Both patients were subsequently reoperated.

Conclusions: Semicontinuous suturing technique for aortic valve replacement is viable with lesser CPB and cross clamp time with larger size valve implantation. It is associated with lesser valve thrombosis. Careful selection of patients can avoid complication of paravalvular leaks.


 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.15

Keywords

Aortic Valve Replacement; Continuous Suturing; Paravalvar Leak.

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