Concomitant mitral valve repair or replacement and coronary revascularization.
Patients undergoing combined mitral valve replacement and coronary revascularization require surgical skill and especially judgment for optimal results. In our hands, cardioplegia has not been a pivotal event in affecting survival, and this probably relates to our previous philosophy of limiting the hypothermic ischemic episodes to 15-minute intervals. Currently, we believe that valve repair, when it can be accomplished, is preferable to valve replacement, especially in the patient with ischemic mitral valve disease. When repair cannot be satisfactorily accomplished, replacement with retention of the posterior leaflet seems clinically to be associated with less disturbance of left ventricular function.
King
R M
RM
Section of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Pluth
J R
JR
D000758:Anesthesia; D003327:Coronary Disease / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery; D009204:Myocardial Revascularization / Q000379:methods*; D011300:Preoperative Care; D011474:Prosthesis Design; D015996:Survival Rate; D013536:Suture Techniques