Division of Cardiac Surgery, Lakeside 3rd Floor, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA.
J Invasive Cardiol. 2023 Feb;35(2):E108-E109. doi: 10.25270/jic/22.00156.
The Cor-Knot surgical tying device (LSI Solutions) is an automated suture fastener with a titanium-crimpable sleeve that facilitates a fast and secure knot. The device is an alternative to hand tying, minimizing operation time, and its increasing use is anticipated for minimally invasive cardiac surgeries or in patients with small surgical anatomy. As its use expands, the likelihood of encountering this knotting device during structural interventions may increase. In this case, during the TAVR procedure, the coplanar angle estimated from preoperative computed tomography scan was easily adjusted referencing the line of Cor-Knot in her aortic annulus without administrating contrast despite poor radiodensity from the Trifecta valve. In the coplanar view, the TAVR valve depth was well appreciated in reference to the Cor-Knot line and the TAVR valve was deployed under controlled pacing without contrast use. We achieved mean aortic pressure gradient of 9 mm Hg without paravalvular leakage or conduction abnormalities. She was discharged to home the next day without renal injury.
Cor-Knot 外科结扎装置（LSI 解决方案）是一种自动化缝线紧固件，带有钛压接套管，可实现快速而牢固的打结。该装置是手工打结的替代方法，可最大程度地缩短手术时间，预计在微创心脏手术或小手术解剖患者中会越来越多地使用。随着其使用的增加，在结构性介入过程中遇到这种结扎装置的可能性可能会增加。在这种情况下，在 TAVR 手术期间，尽管 Trifecta 瓣膜的放射密度较差，但仍可以参考主动脉瓣环中的 Cor-Knot 线轻松调整术前计算机断层扫描估计的共面角度，而无需使用对比剂。在共面视图中，可以参考 Cor-Knot 线很好地了解 TAVR 瓣膜的深度，并且在没有使用对比剂的情况下在受控起搏下部署 TAVR 瓣膜。我们实现了平均主动脉压力梯度为 9mmHg，没有瓣周漏或传导异常。她第二天出院，没有肾损伤。
