title: Valvular Regurgitation After Implantation of Prostheses Secured With Cor-Knot Automated Fasteners.
abstract: Valvular regurgitation is a recognized complication of aortic and mitral valve procedures, with paravalvular leak the primary mechanism and transvalvular leak less common. The Cor-Knot automated fastener (LSI Solutions, Victor, NY) has been shown to be a safe, viable alternative to knot pushers or manual tying for use in these procedures. Here we present two patients in whom the orientation of the Cor-Knot fastener appeared to result in transvalvular regurgitation necessitating a redo operation. With adjunctive use of Cor-Knot devices, fastener orientation relative to valve geometry must be assessed for optimal results.
authors.affiliation: Department of Cardiac Surgery, University of Michigan Cardiovascular Center, Ann Arbor, Michigan. Electronic address: abrescia@med.umich.edu.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Brescia
authors.affiliation: Department of Cardiac Surgery, University of Michigan Cardiovascular Center, Ann Arbor, Michigan.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Bolling
authors.affiliation: Department of Cardiac Surgery, University of Michigan Cardiovascular Center, Ann Arbor, Michigan.
authors.forename: Himanshu J
authors.initials: HJ
authors.lastname: Patel
mesh_terms: D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D053831:Surgical Fixation Devices / Q000009:adverse effects*