NextStitch: Double-Stranded Suture Chain, a Tool to Optimize Approximation of Sutures in Valve Surgery with Echocardiographic Correlation

Authors

  • Robert J. Wiechmann
  • Richard D. Hanna
  • Joseph A. Stange
  • Gilbert H. Johnson
  • Regis I. Fernandes
  • John D. Rozich

DOI:

https://doi.org/10.1532/hsf.788

Abstract

Suture technique for valve replacement surgery has often focused on decreasing the soft tissue injury that leads to pseudoaneurysm formation and associated latent infection. There is universal recognition that precise suture placement is essential for avoiding adverse sequelae while allowing flexibility during the implantation of the prosthesis. The use of a continuous chain of linked horizontal mattress sutures (NextStitch) has allowed maximal precision in the approximation of sutures within the valve annulus. The product was used in a series of consecutive mitral and aortic valve replacements, and typical echocardiographic images from each type of implantation are presented. Postoperative echocardiography images revealed that no perivalvular leaks occurred and that NextStitch did not obscure detailed interrogation or assessment of the valve prosthesis.

References

Bedderman C, Borst HG. 1978. Comparison of two suture techniques and materials: relationship to perivalvular leaks after cardiac valvenreplacement. Cardiovasc Dis Bull Tex Heart Inst 5:354-9.nCerqueira MD, Weissman NJ, Dilsizian V, et al. 2002. Standardized myocardial segmentation and nomenclature for tomographic imaging ofnthe heart: AHA writing group on myocardial segmentation and registration for cardiac imaging. Raleigh, NC: American Society of Echocardiography.nChambers EP, Heath BJ. 1991. Comparison of supraannular and subannular pledgeted sutures in mitral valve replacement. Ann Thorac Surgn51:60-4.nDhasmana JP, Blacksone EH, Kirklin JWK, Kouchoukos NT. 1983. Factors associated with periprosthetic leakage following primary mitral valvenreplacement: with special consideration of suture technique. Ann Surg 35:170-8.nHeath BJ, Warren ET, Nickels B. 1991. Mitral valve replacement: techniques to eliminate myocardial rupture and prevent valvular disruption.nAnn Thorac Surg 52:839-41.nKatz NM, Blackstone EH, Kirklin JW, Bradley EL, Lemons JE. 1981. Suture techniques for atrioventricular valves. J Thorac Cardiovasc Surgn81:528-36.nKirsh MM, Sloan H. 1980. Technique of mitral valve replacement. Ann Thorac Surg 30:490-2.nLaks H, Pearl JM, Barthel SW, Elami A, Sorensen TJ, Milgalter E. 1993. Aortic valve replacement using a continuous suture technique. J Card Surg 8:459-65.nNewton JR, Glower DD, Davis JW, Rankin JS. 1984. Evaluation of suture techniques for mitral valve replacement. J Thorac Cardiovasc Surg 88:248-52.nStiles GM, Kernen JA, Stiles QR. 1986. Suture technique in preventing dehiscence of prosthetic mitral valves. Arch Surg 121:1136-40.n

Published

2005-02-02

How to Cite

Wiechmann, R. J., Hanna, R. D., Stange, J. A., Johnson, G. H., Fernandes, R. I., & Rozich, J. D. (2005). NextStitch: Double-Stranded Suture Chain, a Tool to Optimize Approximation of Sutures in Valve Surgery with Echocardiographic Correlation. The Heart Surgery Forum, 6(1), 24-29. https://doi.org/10.1532/hsf.788

Issue

Section

Article