On-Pump Beating Heart Mitral Valve Surgery without Cross-Clamping the Aorta

Katırcıoğlu, Salih Fehmi; Çiçekçioğlu, Ferit; Tütün, Ufuk; Parlar, Ali İhsan; Babaroglu, Seyhan; Mungan, Ufuk; Aksöyek, Ayşen

doi:10.1111/j.1540-8191.2008.00648.x

Cited by 25 publications

(26 citation statements)

References 20 publications

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“…[1] As an alternative procedure to conventional mitral valve surgery, beating heart mitral valve surgery without cross-clamping the aorta has been used for valvular operations and reoperations with acceptable clinical results. [2][3][4][5][6][7] Sometimes heavy calcification or severe adhesions around the ascending aorta may not allow us to crossclamp the aorta safely. [4] In this situation, hypothermic fibrillatory arrest or deep hypothermia/total circulatory arrest techniques are mostly performed for mitral valve surgery.…”

Section: Discussionmentioning

confidence: 99%

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Porcelain aorta: a new indication for on-pump beating heart mitral valve replacement

Yay¹,

Fehmi²

2012

Turk Gogus Kalp Dama

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Geleneksel olarak mitral kapak replasmanı (MKR) kardiyoplejik arest altında yapılmaktadır. Altmış dokuz yaşında erkek hasta şiddetli dispne, ortopne ve çarpıntı yakınmaları ile kliniğimize başvurdu. Transtorasik ekokardiyografide fibrokalsifik mitral kapak stenozu tespit edildi. Aorta kross-klemp konmadan kardiyopulmoner baypas (CPB) altında atan kalpte MKR uygulandı. Çıkan aort diseke edilmediği için yaralanma ve embolik komplikasyon riski minimize olur. Mitral kapak hastalığı ile birlikte porselen aort; CPB altında atan kalpte MKR'nin yeni bir endikasyonudur. Anah tar söz cük ler: Atan kalp; mitral kapak replasmanı; porselen aort. Conventionally, mitral valve replacement (MVR) is performed under cardioplegic arrest. A 69-years-old male patient was admitted to our clinic with severe dyspnea, orthopnea and palpitation. Transthoracic echocardiography revealed fibro-calcified mitral valve stenosis. Without cross-clamping the aorta, beating heart MVR under cardiopulmonary bypass (CPB) was performed. Since no dissection of the ascending aorta is performed, the risks of injury and embolic complications are minimized. Porcelain aorta with the mitral valve disease is a new indication for beating heart MVR under CPB.

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Section: Discussionmentioning

confidence: 99%

“…A similar technique was described in the literature for cases of redo valve surgery, especially with the open coronary grafts or poor ventricles associated with valvular diseases. [2][3][4][5][6][7] On-pump beating heart mitral valve replacement without cross-clamping along with cannulating the aorta offers a safe approach for the untouched porcelain aorta.…”

mentioning

confidence: 99%

Porcelain aorta: a new indication for on-pump beating heart mitral valve replacement

Yay¹,

Fehmi²

2012

Turk Gogus Kalp Dama

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“…This approach to mitral valve surgery has also been found to be useful in patients requiring mitral valve reoperations [16], as well as in those with ischemic mitral insufficiency [17,18], since myocardial ischemic injury is minimized.…”

Section: Discussionmentioning

confidence: 99%

Resultados da abordagem transeptal para a valva mitral com coração batendo

Salerno¹,

Suarez²,

Panos³

et al. 2009

Rev Bras Cir Cardiovasc

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Results of beating heart mitral valve surgery via the trans-septal approachResultados da abordagem transeptal para a valva mitral com coração batendo Resumo Objetivo: A cirurgia da valva mitral pode ser feita via transatrial ou transeptal. Embora a transatrial seja a preferida, a via transeptal tem sido utilizada mais recentemente e tido um grande valor nas operações com o coração batendo. Mostramos a nossa experiência na cirurgia da valva mitral via transeptal com coração batendo e discutimos seus benefícios e problemas. AbstractObjective: Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls.Methods: Between 2000 and 2007, 214 consecutive patients were operated upon utilizing beating heart technique for mitral valve surgery. The operation was performed via transseptal approach with the aorta unclamped, the heart beating, with normal electrocardiogram and in sinus rhythm.Results Rev Bras Cir Cardiovasc 2009; 24(1): 4-10 and 83 (38.8%) females. Of the prostheses used, 108 (50.5%) were biological, and 39 (18.2%) were mechanical. Mitral repairs were performed in 67 (31.3%) patients. Mean hospital stay was 17.4 ± 20.0 days (range: 3-135 days; median: 11 days). Intra-aortic balloon pump (IABP) utilization was required in 12 (5.6%) of 214 patients. One-month mortality was 7.4%, and re-operation for bleeding was needed in 15 (7%) patients.

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“…Our question to the authors is: if we perform a mitral repair with the mentioned technique, should we skip the well‐accepted water‐leaking test or what should we do? The ratio of mitral valve repair is 11% (10/88) in the paper of Katircioglu et al, 1 which does not reflect the current practice in most cardiac surgery departments. We would like to learn how they have checked the adequacy of their mitral valve repair without injecting water and increasing the left ventricular pressure.…”

mentioning

confidence: 91%

Beating Heart Mitral Valve Surgery: How to Test Mitral Valve Competence After Repair?

Çıkırıkçıoğlu

Myers

Pektok

et al. 2009

Journal of Cardiac Surgery

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On-Pump Beating Heart Mitral Valve Surgery without Cross-Clamping the Aorta

Abstract: In this study, we showed that on-pump beating heart operations without cross-clamping is an acceptable surgical choice for mitral valve disease. Complication rates are low and perioperative mortality is lower than that generally reported with conventional technique.

Cited by 25 publications

References 20 publications

Porcelain aorta: a new indication for on-pump beating heart mitral valve replacement

Porcelain aorta: a new indication for on-pump beating heart mitral valve replacement

Resultados da abordagem transeptal para a valva mitral com coração batendo

Beating Heart Mitral Valve Surgery: How to Test Mitral Valve Competence After Repair?

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