Efficacy and safety of on-pump beating heart surgery for valvular disease

Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery

“…Also, the optimal flow rate are not yet determined, it has been suggested that between 150-250ml/min is the minimal necessary to warrant 4-5% of the total cardiac output [6,9]. A limitation of our study was a small number of patients in both groups to careful evaluate this variable.…”

“…In a systematic review of beating-heart valve surgery, published by Salhiyyah & Taggart [10], 39 reports were reviewed, however only two were randomized control trials. Indeed, the report of Matsumoto et al [9] that studied 50 patients (25 each group ) concluded that the perfusion technique of either retrograde warm blood or blood perfusion on beating had similar outcome including mortality and complications even though ultra microscopy study were not performed, the biochemical markers of myocardial injury were significantly lower in the retrograde technique. Despite of our study limitation present incomplete biochemistry analysis, were similar for the mortality rates and complications.…”

“…Although beating heart valve replacement with continuous coronary sinus perfusion is a good method for myocardial protection because eliminate the use of cardioplegia corollary risk of ischemic reperfusion injury [7,8]. In addition, beating heart surgery produces less cardiac arrhythmia events and no major differences in cerebrovascular events [9,10]. Beating heart technique is being demonstrated to produces less alterations on the biochemistry markers so, have better myocardium protection [11].…”

Safety and efficacy of atrial septal defect closure on normothermic on-pump beating heart

“…Preliminary data show that beating heart surgery is safe for valvular and other complex surgery, weaning from cardiopulmonary bypass is much easier, ventricular fibrillation seldom occurs, patients do better in the post-operative period 6 . The spectrum of on-pump beating heart is widening and it covers atrial septal defect closure, aortic valve surgery, mitral valve surgery, mitral valve surgery without cross clamp, valve surgery in patients with left ventricular dysfunction and lot of others [7][8][9][10][11] . In this study, 30 cases of atrial septal defect closure were done on on-pump beating heart technique and were compared with 30 cases of atrial septal defect closure on cardioplegic arrested heart; the on-pump beating heart technique gave better result.…”

“…Atrial septal defect closure is relatively simple and can be done on onpump beating heart. Surgeons around the world are using on-pump beating heart technique to replace valves, to perform coronary by pass procedures, to correct intracardiac defects and even correction of complex congenital heart defects 9,10 . In this study the bypass time, cross clamp time and weaning time from cardiopulmonary bypass were significantly shorter in Group B patients compared to Group A patients and the occurrence of arrhythmia and the use of direct current shock were significantly lower in Group B patients ( Table Ι).…”