Beating Heart Video-Assisted Mitral Valve Surgery: A Useful Technique for High-Risk Patients

Abstract

Beating-heart strategy can be combined with a minimally invasive approach in patients with severely reduced ventricular function, who require mitral valve surgery.

The Role of the Minimally Invasive Beating Heart Technique in Reoperative Valve Surgery

“…Atrioventricular valve surgery with an unclamped aorta avoids extensive surgical dissection and the need for aortic‐clamping. Good results have also been observed in patients with poor ejection fraction or in cases of multiple valve involvement 10–13 . Nevertheless, it can be complicated by air embolism, because standard de‐airing maneuvers cannot be performed.…”

“…Good results have also been observed in patients with poor ejection fraction or in cases of multiple valve involvement. [10][11][12][13] Nevertheless, it can be complicated by air embolism, because standard de-airing maneuvers cannot be performed. In this setting, continuous CO 2 insufflation and ascending aorta suction play a key role.…”

Redo Mitral Valve Operation via Right Minithoracotomy-"No Touch" Technique

“…7,8) On the other hand, beating heart mitral valve surgery has been performed successfully for appropriately selected patients. 1,9) We simplified the technique for redo cases and mitral valve replacement or annuloplasty was carried out on the beating heart without an aortic clamp or fibrillatory arrest where there was no need to dissect pericardial adhesion at all. In the present study, we review the results of our initial series of minimally invasive beating heart redo mitral valve surgery.…”

Response to Letter:

“…We read with interest the paper by Masroor S, Dance G, and Angeli SJ entitled "Beating heart video-assisted mitral valve surgery: A useful technique for high-risk patients." 1 These authors suggest that video-assisted beating heart mitral valve surgery can offer excellent outcomes in high-risk patients, combining the benefits of a minimally invasive access and the advantages of myocardial continuous perfusion, and we completely agree with this statement.…”