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Continuous suture technique in aortic valve replacement


The aim of the study is to describe our experience in using continuous suture technique for aortic valve replacement and to evaluate the possible advantages of it.


Between February 2001 and October 2011, a total number of 443 patients with aortic valve stenosis underwent aortic valve replacement. It was isolated in 217 patients (group A), combined with coronary vascularisation in 137 cases (group B) and with other concomitant cardiac procedures in 89 cases (group C). In all groups continuous suture technique was used. The most of coronary anastomosis performed “off pump” and only few of them on a beating heart with the support of the pump. Valves used were metallic in 247 cases, stented in bioprostheses in 188 cases and unstented bioprostheses in 8 cases. Sizes of the valves varied from 19 to 27. The valve had always the size of the annulus except for few cases in which the annulus was greater than 27.


The cross-clamp time and bypass time were similar in groups A and B and significantly longer in group C. No perivalvural leak was detected in entry postoperative echocardiograms. There was no need for aortic annulus enlargement. Hospital mortality was 3,5 % in group A, 4,3 % in group B and 3,3 % in group C, respectively. There were no deaths or complications associated with suture technique. During the follow-up period 2 patients of group A and 1 patient of group C developed perivalvural leakage requiring reoperation. The reason was tearing of the annulus tissue. In all cases the metallic valves placed were smaller in size than the enlarged annulus size.


Continuous suture method is safe and useful for aortic valve replacement technique. It is simple, quick and effective, saving bypass and cross clamp time in benefit of other cardiac procedures. Combined with off pump coronary revascularisation, it reduces the danger of the operation. However, in cases with large aortic annulus it must be avoided.

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Correspondence to S Prapas.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated.

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Panagiotopoulos, I., Linardakis, I., Katsavrias, K. et al. Continuous suture technique in aortic valve replacement. J Cardiothorac Surg 8 (Suppl 1), O31 (2013).

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