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International Society For Minimally Invasive Cardiothoracic Surgery

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Titanium Knot Fasteners In Minimally Invasive Aortic Valve Replacement
Charles Lutz, Anna Gleboff, Karikehalli Dilip, Joan Dennis, Ahmad Nazem, Mehdi Marvasti, Anton Cherney, Zhandong Zhou.
St Joseph's Hospital, Syracuse, NY, USA.

OBJECTIVE: The expansion of transcatheter aortic valve replacement (TAVR) mandates that cardiac surgeons adopt minimally invasive approaches to surgical aortic valve replacement (SAVR). Titanium knot fasteners have been shown to greatly facilitate minimally invasive SAVR. Toward this end we review our institutions experience with titanium knot fasteners in minimally invasive right thoracotomy SAVR. METHODS: From 2007 to 2019 430 patients underwent isolated minimally invasive SAVR through a right thoracotomy approach. Patients were stratified based on titanium knot fastener use and pre-operative, intra-operative, and post-operative variables evaluated.RESULTS: See Table below. TNF= Titanium Knot Fastener. TNF use was associated with a significant reduction in procedure and cross-clamp times as well as overall length of stay.
CONCLUSIONS: Based on our experience titanium knot fasteners greatly facilitate minimally invasive right thoracotomy SAVR and should be utilized

Titanium Knot Fasteners in Minimally Invasive SAVR
VariableTNFNoTNFp Value
STS Score (mean)1.52.3<0.05
Procedure time (min)165216<0.05
Cross clamp time (min)6385<0.05
LOS (days)68<0.05
30 day mortality0.3%0%NS
Prolonged ventilation4.2%9.7%NS
Reop Bleeding2.1%3.8%NS
Pacemaker rate3.3%1%NS

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