On-pump beating-heart mitral valve plasty without aortic cross-clamping.
Patients with ischemic cardiomyopathy often have mitral regurgitation, which should be corrected for better long-term survival. Mitral valve surgery is usually performed during cardiopulmonary bypass under the arrested heart condition. The ascending aorta is cross-clamped and the heart is arrested using a cardioplegic solution. However, because ischemic cardiomyopathy patients often have a severely atherosclerotic ascending aorta and low cardiac function, aortic cross-clamping and cardiac arrest increase the risk of postoperative thromboemboli and low cardiac output syndrome. Under the on-pump beating-heart condition, we performed mitral valve plasty concomitant with coronary artery bypass grafting, tricuspid annuloplasty, left ventricular aneurysmectomy, and the maze procedure without aortic cross-clamping for a patient with ischemic dilated cardiomyopathy and bradycardial atrial fibrillation. The patient had no postoperative complications and re covered rapidly. Thus, to prevent serious postoperative complications, on-pump beating-heart mitral valve surgery without aortic cross-clamping may be a suitable surgical option for patients with ischemic cardiomyopathy.
Mizuno
Tomohiro
T
Department of Cardiovascular Surgery, Machida Municipal Hospital, Department of Cardiovascular Surgery, Machida Municipal Hospital 2-15-41 Asahi-Chou, Machida, Tokyo 194-0023, Japan. t-mizuno@yhc.att.ne.jp
Arai
Hirokuni
H
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*