NDLI: An ex-vivo quantitative assessment to determine the optimal aortotomy closure technique

Content Provider	Springer Nature : BioMed Central
Author	Holloway, Daniel D. Appoo, Jehangir J.
Abstract	Background After performing an aortotomy, there are a variety of techniques utilized for suture closure. There is no published data comparing the efficacy of various suture techniques. The goal of this study is to provide an ex-vivo quantitative assessment of resistance to leakage and dehiscence for three aortotomy closure techniques. Materials and methods An ex-vivo model was developed utilizing explanted porcine aorta. Aortotomies were closed using one of three techniques: 1) single layer baseball stitch 2) double layer baseball stitch 3) horizontal mattress stitch with a top layer baseball stitch. The aorta was pressurized with saline using an apparatus which captured all leaked fluid. The intra-aortic pressure was adjusted over 8 increments from 110 to 375 mmHg. Leakage rates were determined at each pressure level. Ten aortotomies were performed for each technique, resulting in 240 calculated leakage rates. Results At all pressures, the horizontal mattress group was measured to have significantly less leakage when compared to single or double layer baseball stitch closures (p < 0.005). There was a trend towards a lower leakage rate in the double layer baseball compared to the single layer baseball stitch. However, this difference is statistically significant only at 300 and 335 mmHg. There were no instances of rupture. Conclusion This study provides the first quantitative comparison of three commonly used aortotomy closure techniques. The running horizontal mattress stitch combined with a baseball stitch provides the greatest resistance to leakage at all pressures. This technique may be superior in clinical scenarios with challenging hemostasis.
Related Links	https://cardiothoracicsurgery.biomedcentral.com/counter/pdf/10.1186/s13019-015-0325-7.pdf
Ending Page	5
Page Count	5
Starting Page	1
File Format	HTM / HTML
ISSN	17498090
DOI	10.1186/s13019-015-0325-7
Journal	Journal of Cardiothoracic Surgery
Issue Number	1
Volume Number	10
Language	English
Publisher	BioMed Central
Publisher Date	2015-09-09
Access Restriction	Open
Subject Keyword	Cardiac Surgery Thoracic Surgery Cardiovascular surgery Animal model Aortic surgery Surgical technique Aortotomy
Content Type	Text
Resource Type	Article
Subject	Surgery Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine
Journal Impact Factor	1.5/2023
5-Year Journal Impact Factor	1.6/2023

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An ex-vivo quantitative assessment to determine the optimal aortotomy closure technique

Author's response to reviews Title:An ex-vivo quantitative assessment to determine the optimal aortotomy closure technique Authors:

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