An ex-vivo quantitative assessment to determine the optimal aortotomy closure technique
نویسندگان
چکیده
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.
منابع مشابه
Author's response to reviews Title:An ex-vivo quantitative assessment to determine the optimal aortotomy closure technique Authors:
متن کامل
Loratadine- Loaded Thermoresponsive Hydogel : Characterization and Ex-vivo Rabbit Cornea Permeability Studies
Poor bioavailability of ophthalmic drops is mainly due to drainage through the nasal-lacrimal duct and a very low permeability through corneal epithelium. The aim of our study was to prepare and characterize an ocular hydrogel of loratadine, as an example of a lipophilic drug, to increase drug concentration and residence time at the site of action in the eye. In this study,a 23full factorial de...
متن کاملLoratadine- Loaded Thermoresponsive Hydogel : Characterization and Ex-vivo Rabbit Cornea Permeability Studies
Poor bioavailability of ophthalmic drops is mainly due to drainage through the nasal-lacrimal duct and a very low permeability through corneal epithelium. The aim of our study was to prepare and characterize an ocular hydrogel of loratadine, as an example of a lipophilic drug, to increase drug concentration and residence time at the site of action in the eye. In this study,a 23full factorial de...
متن کاملDetermining Optimal Risk Assessment Model in Construction Projects (Case study: steel plant construction project)
Introduction: Identifying occupational hazards and managing occupational safety and health risks is the most important mission and responsibility of the health and safety management system in organizations and adopting coded plans to achieve this is the key to continuously improving this system and promoting it. Method: This descriptive-analytic research has been written to determine the optim...
متن کاملEffect of Pretreatment with Fluoride, Chlorhexidine, and Mixed Fluoride-Chlorhexidine Gels on Shear Bond Strength of Orthodontic Brackets: An Ex-Vivo Study
Background and Aim: Orthodontic patients are at an increased risk of caries due to difficulty in plaque control. Antimicrobial agents, such as fluoride and chlorhexidine, can be useful in preventing tooth demineralization. The present study aimed to determine the effect of fluoride and chlorhexidine gels and their mixture on the shear bond strength (SBS) of orthodontic brackets. Materials and ...
متن کامل