[Beating heart surgery for the patient of severe mitral regurgitation with a episode of ventricular fibrillation; report of a case].
A 77-year-old female was admitted to our hospital with a diagnosis of severe mitral regurgitation. Cardiopulmonary revival was done by an emergent resuscitation for the ventricular fibrillation before admission. She had mild anoxic brain damage and brain magnetic resonance imaging (MRI) revealed severe brain atrophy. Chest X-ray showed severe cardiomegaly and congestion. Beating heart mitral valve replacement was planned for the prevention of reperfusion injury. A cardiopulmonary bypass was established by bicaval drainage and aortic return. The prolapse of anterior leaflet was recognized through transeptal approach after aortic clamp. We selected continuous infusion of antegrade cardioplegia for intraoperative coronary perfusion. Mitral valve replacement was done successfully. During intraoperation and postoperation, ventricular fibrillation did not occur. On-pump beating mitral valve replacement is a good procedure to prevent perioperative ventricular arrhythmia especially such the case with a decompressed myocardial function and with a preoperative episode of lethal ventricular arrhythmia necessary for cardiopulmonary resuscitation.
Toyama
Shuji
S
Second Department of Surgery, Yamagata University School of Medicine, Yamagata, Japan.
Sawamura
Y
Y
Yoshimura
Y
Y
Nakashima
K
K
Maekawa
Y
Y
Minagawa
T
T
Kuroda
Y
Y
Sadahiro
M
M
D000368:Aged; D006332:Cardiomegaly / Q000150:complications; D002315:Cardiopulmonary Bypass / Q000379:methods*; D016887:Cardiopulmonary Resuscitation; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications / Q000473:pathology; D007423:Intra-Aortic Balloon Pumping; D008279:Magnetic Resonance Imaging; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D014693:Ventricular Fibrillation / Q000150:complications