Mitral valve redo surgery is a high-risk intervention in particularly patients with low ejection fraction. In these cases, if the absence of aortic insufficiency is documented, beating heart surgery is possible via right thoracotomy in the Trendelenburg position. However, venous drainage, cardiopulmonary bypass temperature, electrolyte balance, and cerebral monitorization are the key considerations for the perfusionist. Herein, we discuss the perfusion standards of mitral valve redo surgery in a patient with low ejection fraction and a stuck mitral valve.
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