Beating-heart valvular surgery: a possible alternative for patients with severely compromised ventricular function.
Cardioplegic arrest of the severely compromised ventricle may make weaning from cardiopulmonary bypass problematic. We report a novel approach to myocardial protection in a patient requiring multi-valve surgery who had an ejection fraction of 15%. Warm oxygenated blood was infused continuously both antegrade and retrograde during aortic valve replacement and mitral and tricuspid valve repair. Adequacy of perfusion was confirmed by the absence of electrocardiographic changes. Clinical improvement suggests that this strategy of myocardial protection warrants further investigation.
Kaplon
Richard J
RJ
Division of Cardiothoracic Surgery, University of Miami/Jackson Memorial Hospital, Florida, USA. rkaplon@med.miami.edu
Pham
Si M
SM
Salerno
Tomas A
TA
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures; D000529:Complementary Therapies; D004452:Echocardiography; D006352:Heart Ventricles / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000150:complications / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications / Q000601:surgery; D012720:Severity of Illness Index; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000601:surgery; D016276:Ventricular Function