Real-time recording of annuloplasty suture dehiscence reveals a potential mechanism for dehiscence cascade  Eric L. Pierce, BS, Javier Gentile, MD, Andrew.

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Real-time recording of annuloplasty suture dehiscence reveals a potential mechanism for dehiscence cascade  Eric L. Pierce, BS, Javier Gentile, MD, Andrew W. Siefert, PhD, Robert C. Gorman, MD, Joseph H. Gorman, MD, Ajit P. Yoganathan, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 152, Issue 1, Pages e15-e17 (July 2016) DOI: 10.1016/j.jtcvs.2016.01.043 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A and B, An annuloplasty ring, instrumented to record tensile forces on individual sutures, was implanted in the mitral valve of a healthy ovine subject using standard technique. C, Implantation was unremarkable. D, Following LVP elevation above 188 mm Hg, 1 suture dehisced. LA, Left atrium; LV, left ventricle; MV, mitral valve; AV, aortic valve. The Journal of Thoracic and Cardiovascular Surgery 2016 152, e15-e17DOI: (10.1016/j.jtcvs.2016.01.043) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 The failed suture dehisced following a peak force of 16.7 N (red); 5.7 N of this force shifted to the 2 adjacent sutures (black). Loading on all other sutures either increased slightly (<1.3 N) or decreased (green). LVP, Left ventricular pressure. The Journal of Thoracic and Cardiovascular Surgery 2016 152, e15-e17DOI: (10.1016/j.jtcvs.2016.01.043) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Dehiscence of an annuloplasty suture adds significant tension to its adjacent 2 sutures. The Journal of Thoracic and Cardiovascular Surgery 2016 152, e15-e17DOI: (10.1016/j.jtcvs.2016.01.043) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions