Introduction:
Cor-Knot (LSI Solutions, Victor, NY) is an automated suture fastening system introduced in 2008 to eliminate manual knot-tying for valvular prosthesis implantation. It also has higher and more consistent holding pressures than manual knots, a quality that would make it a better suturing system for high pressure sites such as aorta. However, aortic root vents and aortic cannulas are typically secured with sutures that are tied with 6 or more knots. During minimally invasive surgery, these knots are tied outside the chest and then slid down on to the aorta. There are instances when the aortic cannulation sites require additional sutures to control residual leaks from an ‘air-knot’. There are also instances of re-exploration for bleeding from these areas. Based on the reports of better holding pressure, we have routinely used Cor-knots for securing aortic root vent/antegrade cardioplegia catheter during minimally invasive procedures for the past 4 years, without any complications related to the suture or the fastener. Here we describe the first reported case of using Cor-Knot for securing large-bore cannula for direct aortic cannulation in minimally-invasive mitral valve surgery.