Mitral valve operation via an extended transseptal approach.
The extended transseptal approach to the mitral valve has been used for 71 consecutive procedures. Four patients died; none had complications directly attributable to the exposure. Twenty underwent a primary reparative procedure; 30, a primary replacement procedure; and 21, a repeat procedure. Despite division of the sinus node artery, 26 of 32 patients with sinus rhythm preoperatively had sinus rhythm postoperatively; 4 had atrial fibrillation postoperatively. Twenty-seven of 37 patients with atrial fibrillation preoperatively had atrial fibrillation postoperatively; 8 had sinus rhythm postoperatively. Because the exposure provided by this extended transseptal approach is superior to that of standard approaches, we now use it routinely for mitral valve operations.
Kon
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ND
Department of Cardiothoracic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157-1096.
Tucker
W Y
WY
Mills
S A
SA
Lavender
S W
SW
Cordell
A R
AR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006346:Heart Septum / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012086:Reoperation; D012849:Sinoatrial Node / Q000503:physiopathology; D013536:Suture Techniques