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J Chest Surg

Published online November 6, 2023

Copyright © Journal of Chest Surgery.

COR-KNOT-Induced Leaflet Perforation: How It Happens and How to Prevent It: A Case Report

Michael Salna , M.D., M.B.A.1, Jack Shanewise , M.D.2, Alex D’Angelo, M.D.1, Isaac George , M.D.1

1Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery and 2Division of Cardiac Anesthesiology, Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA

Correspondence to:Isaac George
Tel 1-212-305-4134
Fax 1-212-305-4134
E-mail ig2006@cumc.columbia.edu
ORCID
https://orcid.org/0000-0001-7770-4450

Received: June 21, 2023; Revised: August 11, 2023; Accepted: August 14, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The COR-KNOT suture fastening device has dramatically improved the efficiency of valve suture fixation. Despite its relative ease of use, there are important considerations in deployment to limit the risk of prosthetic valve injury. Herein, we report a case of iatrogenic aortic bioprosthetic insufficiency caused by poorly positioned COR-KNOTs and outline technical strategies to ensure success.

Keywords: Valve replacement, COR-KNOT, Sutures, Aortic valve, Case report

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J Chest Surg

Published online November 6, 2023

Copyright © Journal of Chest Surgery.

COR-KNOT-Induced Leaflet Perforation: How It Happens and How to Prevent It: A Case Report

Michael Salna , M.D., M.B.A.1, Jack Shanewise , M.D.2, Alex D’Angelo, M.D.1, Isaac George , M.D.1

1Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery and 2Division of Cardiac Anesthesiology, Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA

Correspondence to:Isaac George
Tel 1-212-305-4134
Fax 1-212-305-4134
E-mail ig2006@cumc.columbia.edu
ORCID
https://orcid.org/0000-0001-7770-4450

Received: June 21, 2023; Revised: August 11, 2023; Accepted: August 14, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The COR-KNOT suture fastening device has dramatically improved the efficiency of valve suture fixation. Despite its relative ease of use, there are important considerations in deployment to limit the risk of prosthetic valve injury. Herein, we report a case of iatrogenic aortic bioprosthetic insufficiency caused by poorly positioned COR-KNOTs and outline technical strategies to ensure success.

Keywords: Valve replacement, COR-KNOT, Sutures, Aortic valve, Case report

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