Efficacy, feasibility, and pitfalls of transseptal approach in beating-heart mitral valve surgery.
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.
Salerno
Tomas A
TA
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
Suarez
Maria R
MR
Panos
Anthony L
AL
Macedo
Francisco Igor B
FI
Alba
Julia
J
Brown
Michael
M
Ricci
Marco
M
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*