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.
Department of Cardiothoracic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157-1096.
N D
ND
Kon
W Y
WY
Tucker
S A
SA
Mills
S W
SW
Lavender
A R
AR
Cordell
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