Novel Automated Suturing Technology for Minimally Invasive Aortic Valve Replacements

Joshua K. Wong; Amber L. Melvin; Juan A. Siordia; Devang J. Joshi; Jude S. Sauer; Peter A. Knight

doi:10.1016/j.athoracsur.2017.07.054

Novel Automated Suturing Technology for Minimally Invasive Aortic Valve Replacements

Joshua K. Wong, Amber L. Melvin, Juan A. Siordia, Devang J. Joshi, Jude S. Sauer, Peter A. Knight

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Purpose Annular suture placement during minimally invasive right anterior thoracotomy aortic valve replacements (MI-AVR) can be challenging. We present the early clinical experience with novel automated suturing technology that may reduce the technical difficulty of this operation. Description The technology presented involves an automated articulating suturing device that simultaneously drives dual-curved needles through the aortic annulus to place a pledgeted horizontal mattress suture remotely; a second device with 2 straight needles places suture through the sewing cuff of a prosthetic heart valve. Evaluation Automated annular suturing was used in five MI-AVR procedures, which were successfully completed, with no paravalvular leaks detected and a mean aortic valve gradient of 6.4 mm Hg postprocedure. Mean aortic cross-clamp and cardiopulmonary bypass times were 100 and 134 minutes, respectively. All 5 patients were successfully discharged home, with a mean intensive care unit and total length of stay of 2 and 7 days, respectively. Conclusions Automated suturing during MI-AVRs is feasible and may reduce the technical challenge of this operation. Further research is necessary to determine its effect on patient outcomes.

Original language	English (US)
Pages (from-to)	645-649
Number of pages	5
Journal	Annals of Thoracic Surgery
Volume	105
Issue number	2
DOIs	https://doi.org/10.1016/j.athoracsur.2017.07.054
State	Published - Feb 2018
Externally published	Yes

Bibliographical note

Funding Information:
Drs Wong, Melvin, Joshi, and Siordia were previous recipients of a research grant from LSI SOLUTIONS. Dr Knight is a research consultant for LSI SOLUTIONS but received no financial compensation or other remuneration for this work. Dr Sauer is the founder and owner of LSI SOLUTIONS. The tested technology was donated to the study for the purposes of this clinical evaluation. The authors maintained full control over the study and acknowledge their responsibility for its design, analysis, honesty, and accuracy.

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title = "Novel Automated Suturing Technology for Minimally Invasive Aortic Valve Replacements",

abstract = "Purpose Annular suture placement during minimally invasive right anterior thoracotomy aortic valve replacements (MI-AVR) can be challenging. We present the early clinical experience with novel automated suturing technology that may reduce the technical difficulty of this operation. Description The technology presented involves an automated articulating suturing device that simultaneously drives dual-curved needles through the aortic annulus to place a pledgeted horizontal mattress suture remotely; a second device with 2 straight needles places suture through the sewing cuff of a prosthetic heart valve. Evaluation Automated annular suturing was used in five MI-AVR procedures, which were successfully completed, with no paravalvular leaks detected and a mean aortic valve gradient of 6.4 mm Hg postprocedure. Mean aortic cross-clamp and cardiopulmonary bypass times were 100 and 134 minutes, respectively. All 5 patients were successfully discharged home, with a mean intensive care unit and total length of stay of 2 and 7 days, respectively. Conclusions Automated suturing during MI-AVRs is feasible and may reduce the technical challenge of this operation. Further research is necessary to determine its effect on patient outcomes.",

author = "Wong, {Joshua K.} and Melvin, {Amber L.} and Siordia, {Juan A.} and Joshi, {Devang J.} and Sauer, {Jude S.} and Knight, {Peter A.}",

note = "Funding Information: Drs Wong, Melvin, Joshi, and Siordia were previous recipients of a research grant from LSI SOLUTIONS. Dr Knight is a research consultant for LSI SOLUTIONS but received no financial compensation or other remuneration for this work. Dr Sauer is the founder and owner of LSI SOLUTIONS. The tested technology was donated to the study for the purposes of this clinical evaluation. The authors maintained full control over the study and acknowledge their responsibility for its design, analysis, honesty, and accuracy. ",

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doi = "10.1016/j.athoracsur.2017.07.054",

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AU - Melvin, Amber L.

AU - Siordia, Juan A.

AU - Joshi, Devang J.

AU - Sauer, Jude S.

AU - Knight, Peter A.

N1 - Funding Information: Drs Wong, Melvin, Joshi, and Siordia were previous recipients of a research grant from LSI SOLUTIONS. Dr Knight is a research consultant for LSI SOLUTIONS but received no financial compensation or other remuneration for this work. Dr Sauer is the founder and owner of LSI SOLUTIONS. The tested technology was donated to the study for the purposes of this clinical evaluation. The authors maintained full control over the study and acknowledge their responsibility for its design, analysis, honesty, and accuracy.

PY - 2018/2

Y1 - 2018/2

N2 - Purpose Annular suture placement during minimally invasive right anterior thoracotomy aortic valve replacements (MI-AVR) can be challenging. We present the early clinical experience with novel automated suturing technology that may reduce the technical difficulty of this operation. Description The technology presented involves an automated articulating suturing device that simultaneously drives dual-curved needles through the aortic annulus to place a pledgeted horizontal mattress suture remotely; a second device with 2 straight needles places suture through the sewing cuff of a prosthetic heart valve. Evaluation Automated annular suturing was used in five MI-AVR procedures, which were successfully completed, with no paravalvular leaks detected and a mean aortic valve gradient of 6.4 mm Hg postprocedure. Mean aortic cross-clamp and cardiopulmonary bypass times were 100 and 134 minutes, respectively. All 5 patients were successfully discharged home, with a mean intensive care unit and total length of stay of 2 and 7 days, respectively. Conclusions Automated suturing during MI-AVRs is feasible and may reduce the technical challenge of this operation. Further research is necessary to determine its effect on patient outcomes.

AB - Purpose Annular suture placement during minimally invasive right anterior thoracotomy aortic valve replacements (MI-AVR) can be challenging. We present the early clinical experience with novel automated suturing technology that may reduce the technical difficulty of this operation. Description The technology presented involves an automated articulating suturing device that simultaneously drives dual-curved needles through the aortic annulus to place a pledgeted horizontal mattress suture remotely; a second device with 2 straight needles places suture through the sewing cuff of a prosthetic heart valve. Evaluation Automated annular suturing was used in five MI-AVR procedures, which were successfully completed, with no paravalvular leaks detected and a mean aortic valve gradient of 6.4 mm Hg postprocedure. Mean aortic cross-clamp and cardiopulmonary bypass times were 100 and 134 minutes, respectively. All 5 patients were successfully discharged home, with a mean intensive care unit and total length of stay of 2 and 7 days, respectively. Conclusions Automated suturing during MI-AVRs is feasible and may reduce the technical challenge of this operation. Further research is necessary to determine its effect on patient outcomes.

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Novel Automated Suturing Technology for Minimally Invasive Aortic Valve Replacements

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