Extended Vertical Transseptal Approach versus Transseptal Approach for Mitral Valve Operation

Wang, Qi; Wu, Xiao; Wei, Wuli; Xiang, Ming

doi:10.1532/hsf98.2014317

Cited by 3 publications

(3 citation statements)

References 14 publications

(16 reference statements)

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“…Furthermore, postoperative pleural effusion was detected more significantly among the trans-septal group than those in left atriotomy group. Similarly, there was no increased risk of permanent pacemaker insertion after TS, in addition to the majority of arrhythmias are transient, in accordance to some research (14,21) . While, in their multivariate study, Lukac et al found that the TS method was an independent risk factor for pacemaker insertion (hazard ratio [HR]: 2.2, 95% confidence level).CI: 1.2-4.1; p = 0.014 (22) .…”

Section: Discussionsupporting

confidence: 90%

A Comparative Study between Postoperative Arrhythmia Between Bilateral Trans-Septal Approach and Left Atriotomy in Mitral Valve Surgery

2024

The Egyptian Journal of Hospital Medicine

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Background: Although the intra-septal method offers better access to the mitral valve, there are concerns over the increased likelihood of postoperative atrial fibrillation and full heart block. Aim: To compare incidence of postoperative arrhythmia between bi-atrial trans-septal approach and left atrial approach in mitral valve surgery, to improve outcome and quality of life to reduce morbidity and mortality. Patients and methods: This comparative prospective clinical trial was done in Cardio-

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Section: Discussionsupporting

confidence: 90%

A Comparative Study between Postoperative Arrhythmia Between Bilateral Trans-Septal Approach and Left Atriotomy in Mitral Valve Surgery

2024

The Egyptian Journal of Hospital Medicine

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“…Perhaps the differences between our results and those reported by the Nienaber and Glower [32] study are due to the shorter atrial incision, faster atrial closure time, and lesser injury to the sinus nodal artery in the mini-TS approach. Wang et al [33] concluded that the extending vertical transseptal approach affords excellent exposure of the mitral valve.…”

Section: Left Ventricular Outflow Tract [Lvot] Obstruction May Occur After Redo Surgical Mitral Valve Replacement [Smvr]mentioning

confidence: 99%

Retrospective Study of Redo Mitral Valve Surgery in Cardiothoracic Surgery Department Al-Hussein University Hospital

Hassan

Elsayaad

Sharaa

2021

International Journal of Medical Arts

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Background: Cardiac surgery became more common. This led to increased redo-surgeries with expected increase of overall complications after the redo. The used approach could affect overall outcome. However, this is not addressed well in literature. Aim of the work: To examine the overall outcome of patients underwent redo-mitral valve replacement [redo-MVR]. Patients and methods: This study is a retrospective comparative study that was conducted in Cardiothoracic Surgery Department, Al-Hussein University Hospital in the last three years [from January, 1st, 2017 to the end of December 2019]. Collected data included patient demographics, surgical approach and overall short-term outcome.Results: The current study included 37 patients; the mean age was 45.19±9.16 years. The most common indication for redo was pannus formation [48.6%], followed by thrombosis [45.9%]. There was no significant difference between preoperative and postoperative heart rhythm. Redo sternotomy was the commonest, reported in all patients, and femoral bypass done for 3 patients. Trans-atrial approach reported in 24 patients [64.86%] while Trans-septal approach reported in 13 patients [35.14%]. No significant difference between preoperative and postoperative echo data [Ejection Friction, left atrial dimension or left ventricle end diastolic dimension]. However, there was significant reduction of left ventricle end-systolic dimension [LVESD], pulmonary artery systolic pressure [PASP] and pressure gradient [PG] cross mitral valve after operation. Reoperation for bleeding was not reported in any cases, while need for new pacemaker reported in 2 patients [5.41%], new postoperative neurological dysfunction reported in new heart failure or need to dialysis in two patients [5.41%]. The postoperative arrhythmia was reported in 7 patients [18.9%] and mortality was occurred in three patients [10.8%]. Conclusion:The results of the current study showed that, both transseptal and transatrial approaches are comparable and no one is superior to the other.

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“…15 Emerging minimally invasive approaches may eventually supplant the traditional atriotomy or transseptal approaches that are currently widely used for MV surgeries. 16 Reports of the frequency of postoperative arrhythmias in cohorts of patients undergoing these procedures, compared to patients who underwent more invasive traditional procedures, will shed light on the relationship between MV approach and the creation of electrophysiological substrates.…”

Section: Voltage Mappingmentioning

confidence: 99%

Prevalence of intra‐atrial reentrant tachycardia following mitral valve surgery: Relationship to surgical approach

Gandhavadi

Cox

2020

J Card Surg

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Background and Aim Mitral valve (MV) surgeries create electrophysiological substrates that give rise to postoperative arrhythmias. MV surgical procedures have been associated with macro‐ and microreentrant arrhythmogenic circuits, as well as circuits involving the atrial roof. It is not well understood why such arrhythmias develop; therefore, the aim of this study was to describe clinical and procedure characteristics associated with atrial arrhythmias in patients with prior MV surgery. Methods This retrospective chart review evaluated patients who had prior MV surgery and ablation procedures for atrial tachycardia between 2014 and 2018 (n = 20). Patients were classified into those exhibiting typical atrial flutter or another atrial tachyarrhythmia. Results Within the 20 patient cases reviewed, 30 arrhythmias were documented. Two‐thirds of arrhythmias were typical atrial flutter; the percent incidence of arrhythmias originating in the right atrial (RA) roof, around the right atriotomy scar, in the left atrium, and at the crista terminalis was 20%, 3%, 7%, and 7%, respectively. Nearly every case of RA roof flutter (n = 5/6) and most arrhythmias (n = 20/30) occurred in patients who had a transseptal approach during MV surgery. Voltage maps did not show clear differences in scarring between groups. Conclusion Results from this study suggest that an arrhythmogenic substrate for RA roof tachycardias is generated by transseptal approaches for MV surgery. This substrate is not clearly related to a surgical scar. These data suggest that other approaches should be considered for MV surgeries. Additionally, more research is needed to determine the mechanism for this nonscar‐related arrhythmia substrate.

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Extended Vertical Transseptal Approach versus Transseptal Approach for Mitral Valve Operation

Abstract: The extended vertical transseptal approach not only affords excellent exposure of the mitral valve, but also is safe for maintaining sinus node function compared with the transseptal approach.

Cited by 3 publications

References 14 publications

A Comparative Study between Postoperative Arrhythmia Between Bilateral Trans-Septal Approach and Left Atriotomy in Mitral Valve Surgery

A Comparative Study between Postoperative Arrhythmia Between Bilateral Trans-Septal Approach and Left Atriotomy in Mitral Valve Surgery

Retrospective Study of Redo Mitral Valve Surgery in Cardiothoracic Surgery Department Al-Hussein University Hospital

Prevalence of intra‐atrial reentrant tachycardia following mitral valve surgery: Relationship to surgical approach

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