Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis
ObjectivesTo date, there is no evidence regarding the safety of automated titanium fastener compared with hand-tied knots for prosthesis fixation in infective endocarditis.MethodsBetween January 2016 and December 2022, a total of 220 patients requiring surgery for infective endocarditis were include...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1363336/full |
| _version_ | 1827376272684089344 |
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| author | Amila Kahrovic Philipp Angleitner Harald Herkner Paul Werner Thomas Poschner Leila Alajbegovic Alfred Kocher Marek Ehrlich Günther Laufer Martin Andreas |
| author_facet | Amila Kahrovic Philipp Angleitner Harald Herkner Paul Werner Thomas Poschner Leila Alajbegovic Alfred Kocher Marek Ehrlich Günther Laufer Martin Andreas |
| author_sort | Amila Kahrovic |
| collection | DOAJ |
| description | ObjectivesTo date, there is no evidence regarding the safety of automated titanium fastener compared with hand-tied knots for prosthesis fixation in infective endocarditis.MethodsBetween January 2016 and December 2022, a total of 220 patients requiring surgery for infective endocarditis were included in this retrospective analysis. The primary study endpoint was re-endocarditis during follow-up. The secondary study endpoints included stroke onset, all-cause mortality, and a composite outcome of either re-endocarditis, stroke, or all-cause mortality during follow-up.ResultsSuture-securing with an automated titanium fastener was performed in 114 (51.8%) patients, whereas the conventional technique of hand knot-tying was used in 106 (48.2%) patients. The risk of re-endocarditis was significantly lower in the automated titanium fastener group, as shown in a multivariable proportional competing risk regression model (adjusted sub-hazard ratio 0.33, 95% confidence interval 0.11–0.99, p = 0.048). The multivariable Cox proportional hazards regression analysis showed that the automated titanium fastener group was not associated with an increased risk of stroke-onset or attaining the composite outcome, respectively, (adjusted hazard ratio 0.54, 95% confidence interval 0.27–1.08, p = 0.082), (adjusted hazard ratio 0.65, 95% confidence interval 0.42–1.02, p = 0.061). Also, this group was not associated with an increased risk of all-cause mortality, as demonstrated in the multivariable Poisson regression analysis (adjusted incidence-rate ratio 1.42, 95% confidence interval 0.83–2.42, p = 0.202).ConclusionsThe use of automated titanium fastener device seems to be safe for infective endocarditis. Analyses of larger cohorts are required. |
| first_indexed | 2024-03-08T12:08:25Z |
| format | Article |
| id | doaj.art-26a29fff17554623bbf92fb70deec5c9 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-08T12:08:25Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-26a29fff17554623bbf92fb70deec5c92024-01-23T04:19:05ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-01-011110.3389/fcvm.2024.13633361363336Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditisAmila Kahrovic0Philipp Angleitner1Harald Herkner2Paul Werner3Thomas Poschner4Leila Alajbegovic5Alfred Kocher6Marek Ehrlich7Günther Laufer8Martin Andreas9Department of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Emergency Medicine, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaObjectivesTo date, there is no evidence regarding the safety of automated titanium fastener compared with hand-tied knots for prosthesis fixation in infective endocarditis.MethodsBetween January 2016 and December 2022, a total of 220 patients requiring surgery for infective endocarditis were included in this retrospective analysis. The primary study endpoint was re-endocarditis during follow-up. The secondary study endpoints included stroke onset, all-cause mortality, and a composite outcome of either re-endocarditis, stroke, or all-cause mortality during follow-up.ResultsSuture-securing with an automated titanium fastener was performed in 114 (51.8%) patients, whereas the conventional technique of hand knot-tying was used in 106 (48.2%) patients. The risk of re-endocarditis was significantly lower in the automated titanium fastener group, as shown in a multivariable proportional competing risk regression model (adjusted sub-hazard ratio 0.33, 95% confidence interval 0.11–0.99, p = 0.048). The multivariable Cox proportional hazards regression analysis showed that the automated titanium fastener group was not associated with an increased risk of stroke-onset or attaining the composite outcome, respectively, (adjusted hazard ratio 0.54, 95% confidence interval 0.27–1.08, p = 0.082), (adjusted hazard ratio 0.65, 95% confidence interval 0.42–1.02, p = 0.061). Also, this group was not associated with an increased risk of all-cause mortality, as demonstrated in the multivariable Poisson regression analysis (adjusted incidence-rate ratio 1.42, 95% confidence interval 0.83–2.42, p = 0.202).ConclusionsThe use of automated titanium fastener device seems to be safe for infective endocarditis. Analyses of larger cohorts are required.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1363336/fullinfective endocarditisautomated titanium fastenerhand-tied knotssuture-securing techniquesprosthesis fixation |
| spellingShingle | Amila Kahrovic Philipp Angleitner Harald Herkner Paul Werner Thomas Poschner Leila Alajbegovic Alfred Kocher Marek Ehrlich Günther Laufer Martin Andreas Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis Frontiers in Cardiovascular Medicine infective endocarditis automated titanium fastener hand-tied knots suture-securing techniques prosthesis fixation |
| title | Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis |
| title_full | Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis |
| title_fullStr | Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis |
| title_full_unstemmed | Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis |
| title_short | Automated titanium fastener vs. hand-tied knots for prosthesis fixation in infective endocarditis |
| title_sort | automated titanium fastener vs hand tied knots for prosthesis fixation in infective endocarditis |
| topic | infective endocarditis automated titanium fastener hand-tied knots suture-securing techniques prosthesis fixation |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1363336/full |
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