Related Experiment Video
Updated: Mar 29, 2026
09:13
Polytetrafluoroethylene PTFE as a Suture Material in Tendon Surgery
Published on: October 6, 2022
4.3K
Expanded Polytetrafluoroethylene for Chordal Replacement: Preventing Knot Failure.
Jacob R Miller1, Corey R Deeken1, Shuddhadeb Ray1
1Washington University in St. Louis School of Medicine and Department of Cardiothoracic Surgery, Barnes-Jewish Hospital, St. Louis, Missouri.
The Annals of Thoracic Surgery
|December 15, 2015
Summary
Knot security with expanded polytetrafluoroethylene sutures like Gore-Tex and Chord-X is crucial for mitral valve repair. While strong, these sutures risk unraveling with fewer than 10 throws, especially at physiologic conditions.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- Expanded polytetrafluoroethylene (ePTFE) sutures are widely used for mitral valve chordal replacement.
- Knot security is a critical concern due to the material properties of ePTFE, which can lead to unraveling.
Purpose of the Study:
- To compare the knot security of Gore-Tex and Chord-X sutures.
- To determine the minimum number of throws required to prevent knot failure in mitral valve repair.
Main Methods:
- Evaluated knot maximal load based on suture type (Gore-Tex CV-5, Chord-X 3-0), number of throws (6-12), and tension (10-85%).
- Assessed failure modes (unraveling vs. breaking) and load to failure.
Main Results:
- Overall mean load to failure was 11.1 ± 5.8 N.
- Knot failure occurred primarily due to unraveling (59%) at lower loads (7.1 ± 4.1 N) compared to breaking (41%) at higher loads (16.7 ± 2.0 N).
- Gore-Tex exhibited higher mean load to failure than Chord-X, but both sutures unraveled at 2 N with fewer than 10 throws.
Conclusions:
- Expanded polytetrafluoroethylene sutures possess sufficient strength to resist breakage.
- A significant risk of knot unraveling exists under physiologic conditions when fewer than 10 throws are used, compromising mitral valve repair integrity.
