title: Mitral valve replacement with the beating heart technique in a patient with previous bypass graft from ascending to descending aorta due to aortic coarctation.
abstract: OBJECTIVE
  Conventional mitral valve replacement (MVR) is carried out under cardioplegic arrest with cross-clamping of the ascending aorta during cardiopulmonary bypass. In this case, MVR was performed with on-pump beating heart technique without cross-clamping the aorta because of the diffuse adhesion around the ascending aorta, and tube graft presence between ascending and descending aortas.
  
  
  METHODS
  A 47-year-old female patient had aorto-aortic bypass graft from ascending aorta to descending aorta with median sternotomy and left thoracotomy in single stage because of aortic coarctation 2 years ago in our cardiac center. She was admitted to the hospital with palpitation and dyspnea on mild exertion. Transthoracic echocardiography revealed 4th degree mitral insufficiency.
  
  
  RESULTS
  MVR was carried out through remedian sternotomy with on-pump beating heart technique without cross-clamping the aorta.
  
  
  CONCLUSIONS
  MVR with on-pump beating heart technique offers a safe approach when excessive dissection is required to place cross-clamp on the ascending aorta.
authors.affiliation: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Ferit
authors.initials: F
authors.lastname: Cicekcioglu
authors.forename: A Ihsan
authors.initials: AI
authors.lastname: Parlar
authors.forename: Aysen
authors.initials: A
authors.lastname: Aksoyek
authors.forename: Seyhan
authors.initials: S
authors.lastname: Babaroglu
authors.forename: Kerem
authors.initials: K
authors.lastname: Yay
authors.forename: Ahmet K
authors.initials: AK
authors.lastname: Irdem
authors.forename: S Fehmi
authors.initials: SF
authors.lastname: Katircioglu
mesh_terms: D001011:Aorta / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D004417:Dyspnea; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*