title: Efficacy, feasibility, and pitfalls of transseptal approach in beating-heart mitral valve surgery.
abstract: BACKGROUND
  Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls.
  
  
  METHODS
  Between 2000 and 2007, 214 patients underwent mitral valve procedures using the beating-heart surgical approach.
  
  
  RESULTS
  One hundred and forty-three patients (66.8%) had mitral valve replacement, 68 patients (31.7%) mitral valve repair, and 82 patients (38.3%) concomitant valve procedures. Coronary artery bypass grafting was simultaneously performed in 30 (14%) patients. Thirty-day mortality was 7.4%, reoperation for bleeding 7%, stroke 0.4%, and myocardial infarction 0.4%, and failed mitral valve repair 0.9%.
  
  
  CONCLUSIONS
  Our experience suggests that beating-heart mitral valve surgery is facilitated by using the trans-septal approach.
authors.affiliation: Division of Cardiothoracic Surgery and Perfusion, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, Florida 33136, USA. tsalerno@med.miami.edu
authors.forename: Tomas A
authors.initials: TA
authors.lastname: Salerno
authors.forename: Maria R
authors.initials: MR
authors.lastname: Suarez
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Panos
authors.forename: Francisco Igor B
authors.initials: FI
authors.lastname: Macedo
authors.forename: Julia
authors.initials: J
authors.lastname: Alba
authors.forename: Michael
authors.initials: M
authors.lastname: Brown
authors.forename: Marco
authors.initials: M
authors.lastname: Ricci
mesh_terms: D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005431:Florida; D006325:Heart Atria / Q000473:pathology / Q000601:surgery*; D006346:Heart Septum / Q000473:pathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*