Evidence map›Paper›PMID 38913864›Full record

ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2024

Automated titanium fastener for surgical aortic valve replacement-preventive role for infective endocarditis?

Amila Kahrovic, Harald Herkner, Philipp Angleitner, Paul Werner, Alfred Kocher, Marek Ehrlich, Dominik Wiedemann, Guenther Laufer, Paul Simon, Martin Andreas

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Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Automated Suture Securing Technology in Mitral Valve Surgery: A Strategy to Reduce Prosthetic Dehiscence?European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
    Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Amila KahrovicDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0009-0000-1597-720X
Harald HerknerDepartment of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
Philipp AngleitnerDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-8378-0633
Paul WernerDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0003-0925-6160
Alfred KocherDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-2818-2227
Marek EhrlichDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
Dominik WiedemannDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-2055-8293
Guenther LauferDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0001-7257-110X
Paul SimonDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
Martin AndreasDepartment of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0003-4950-5432

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEvidence on long-term clinical outcomes considering suture-securing techniques used for surgical aortic valve replacement is still uncertain.

methodsA total of 1405 patients who underwent surgical aortic valve replacement between January 2016 and December 2022 were included and grouped according to the suture-securing technique used (automated titanium fastener versus hand-tied knots). The occurrence of infective endocarditis during follow-up was set as the primary study end-point. As secondary study end-points, stroke, all-cause mortality and a composite outcome of either infective endocarditis, stroke, or all-cause mortality were assessed.

resultsThe automated titanium fastener was used in 829 (59%) patients, whereas the hand-knot tying technique was used in 576 (41%) patients. The multivariable proportional competing risk regression analysis showed a significantly lower risk of infective endocarditis during follow-up in the automated titanium fastener group (adjusted sub-hazard ratio 0.44, 95% confidence interval 0.20-0.94, P = 0.035). The automated titanium fastener group was not associated with an increased risk of mortality or attaining the composite outcome, respectively (adjusted hazard ratio 0.81, 95% confidence interval 0.60-1.09, P = 0.169; adjusted hazard ratio 0.82, 95% confidence interval 0.63-1.07, P = 0.152). This group was not associated with an increased risk of stroke (adjusted sub-hazard ratio 0.82, 95% confidence interval 0.47-1.45, P = 0.504). Also, a significantly lower rate of early-onset infective endocarditis was observed in the automated titanium fastener group, (0.4% vs 1.4%, P = 0.032).

conclusionsSuture-securing with an automated titanium fastener device appears to be superior compared to the hand-knot tying technique in terms of lower risk of infective endocarditis.

Indexed as

Aortic ValveEndocarditisHeart Valve Prosthesis ImplantationSuture TechniquesTitaniumAgedFemaleHeart Valve ProsthesisHumansMaleMiddle AgedRetrospective StudiesTitaniumAutomated titanium fastenerHand-tied knotsInfective endocarditisSurgical aortic valve replacement

Identifiers

PMID38913864
PMCPMC11211209

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.