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.