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- W2085455046 abstract "We read with great interest the effect of valve suture technique on the incidence of paraprosthetic regurgitation reported by Nair and colleagues [1Nair S.K. Bhatnagar G. Valencia O. Chandrasekaran V. Effect of valve suture technique on incidence of paraprosthetic regurgitation and 10-year survival.Ann Thorac Surg. 2010; 89: 1171-1179Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar]. In that article, a continuous suture technique (CST) for valve replacement increased the risk of significant paraprosthetic regurgitation after aortic and mitral valve replacements and the risk of redo valve replacement after aortic valve replacement. Given that the authors did not describe the suture technique in detail, we suppose that the outcomes were caused by inaccurate stitches rather than the suture technique. The fragmentary outcomes should not be regarded as the usual outcome of the recent CST used for valve replacement. Supraannular placement of aortic valve prostheses is now frequently used to overcome patient–prosthesis mismatch. Although a long 2-0 polypropylene suture is frequently used for CST, the thick suture with a thick needle may damage the thin, tiny aortic annulus. Instead, a 3-0 polypropylene suture, which is frequently used for replacing a vascular graft for aortic aneurysm, is strong enough to fix the valve prosthesis to the aortic annulus without delayed suture disruption. To securely fix the valve prosthesis to the aortic annulus, more stitches may be required with the CST than with the pledgeted interrupted mattress suture technique. The technical outcomes of valve replacement do not depend on whether the CST or the interrupted suture technique is used but on whether or not the stitches are performed meticulously. All stitches for the CST should be sufficiently deep, and the suture line should be tightened with nerve hooks to securely fix the prosthesis to the annulus [2Choi J.B. Kim J.H. Park H.K. et al.Aortic valve replacement using continuous suture technique in patients with aortic valve disease.Korean J Thorac Cardiovasc Surg. 2013; 46: 249-255Crossref PubMed Scopus (7) Google Scholar]. A supporting pericardial strip in the suture line between the aortic annulus and the sewing ring seems cumbersome and unnecessary. The advantages of the CST are that the remnant annular (leaflet) tissue is buried in the suture line and that no pledgets are present on the suture line. Recently, we used the continuous 3-0 polypropylene suture technique in 200 or more patients with aortic valve replacement and mitral valve replacement, none of whom ever experienced paraprosthetic leakage or regurgitation (median follow-up time, 2.5 years). We are now interested in the CST because of the advantages described here, although we used the everting or noneverting pledgeted mattress suture technique for valve replacements without any significant problems for approximately 30 years. The CST for valve replacements should not be denounced as an incorrect suture technique that causes delayed paravalvular regurgitation. Therefore, the CST is safe and useful for valve replacement. Effect of Valve Suture Technique on Incidence of Paraprosthetic Regurgitation and 10-Year SurvivalThe Annals of Thoracic SurgeryVol. 89Issue 4PreviewThe primary objective was to estimate the risk of paraprosthetic regurgitation (PPR) after aortic (AVR) and mitral valve replacement (MVR) using interrupted (IN) or semicontinuous (SC) sutures. The secondary objective was to estimate the risk of redo valve surgery and 10-year survival after valve replacement performed using either suture technique. Full-Text PDF" @default.
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- W2085455046 date "2015-02-01" @default.
- W2085455046 modified "2023-10-18" @default.
- W2085455046 title "Effect of Continuous Suture Technique for Aortic and Mitral Valve Replacement" @default.
- W2085455046 cites W1980807862 @default.
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- W2085455046 doi "https://doi.org/10.1016/j.athoracsur.2014.08.001" @default.
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