title: Exposure of the mitral valve by transecting the ascending aorta during aortic and mitral valve replacement.
abstract: Combined aortic and mitral valve operations are still considered major cardiac surgical procedures. The duration of aortic cross-clamping and cardiopulmonary bypass is longer, which increases morbidity and mortality for these combined, complicated operations. Aortic valve exposure is generally satisfactory, but mitral valve exposure may be difficult and add to the length of the aortic cross-clamping time. We have exposed the mitral valve by transecting the ascending aorta, and retracting both ends apart, to give direct access through the dome of the left atrium in 7 patients. This approach gave good exposure and did not increase the risk of complications. Exposure of the mitral valve through the left atrium using a superior approach, by transecting the ascending aorta, is a good option for patients with multiple cardiac conditions who are undergoing combined aortic and mitral valve operations.
authors.affiliation: Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania 15232, USA. rajca@ssh.edu
authors.forename: V R
authors.initials: VR
authors.lastname: Machiraju
authors.forename: C A
authors.initials: CA
authors.lastname: Lima
authors.forename: M H
authors.initials: MH
authors.lastname: Culig
authors.forename: R D
authors.initials: RD
authors.lastname: Bennett
authors.forename: N S
authors.initials: NS
authors.lastname: Thakur
mesh_terms: D001011:Aorta / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D013536:Suture Techniques