Use of barbed suture in robot-assisted mitral valvuloplasty

Robot-assisted annuloplasty using a mitral band has a major issue: suturing is time consuming because knot tying is performed mechanically under endoscopic view. We suture the mitral band to the native valve by running sutures using the V-Loc barbed suture nonabsorbable wound closure device (Covidien, Mansfield, MA) with 3-0 monofilament. This technique allows rapid suturing of the band to the valve. Although conventional interrupted sutures leave multiple knots protruding on the band, using the V-Loc eliminates the need to tie surgical knots and leaves a clean surface, which may potentially reduce the risk of thrombogenesis. This method is highly useful for robotic mitral annuloplasty.