title: Beating heart versus conventional mitral valve surgery.
abstract: OBJECTIVE
  The present study aimed to compare the results of beating heart technique and conventional mitral valve surgery (MVS).
  
  
  METHODS
  Three hundred and nineteen patients who underwent MVS between April 2005 and December 2006 were enrolled in the study. While 125 patients underwent beating heart MVS (group 1), the conventional approach was used for 194 patients (group 2). Of those patients who underwent beating heart MVS, 75 underwent MVS without cross-clamping the aorta. Coronary sinus retroperfusion was used during surgery in the remaining 50 patients. The right anterolateral thoracotomy was performed in nine out of the 29 patients requiring re-operation, while resternotomy was performed in 20.
  
  
  RESULTS
  No significant differences were shown between the groups in the preoperative period in terms of the Parsonnet mortality score, Ontario mortality score, and length of intensive care stay. However, there were significant differences with respect to EuroSCORE risk score, EuroSCORE mortality, and Parsonnet risk score, and length of hospital stay according to Ontario risk scoring. It was established that the patients in group 1 had a shorter length of hospital stay [group 1: six days (range, 4-37 days); group 2: 10 days (range, 4-62 days)]. Group 1 was observed to have shorter time periods when the groups were compared regarding operative time [group 1: 130 min (range, 100-270 min); group 2: 240 min (range, 100-360 min)], cross-clamping (XCL) time [group 1: 27.5 min (range, 3-99 min); group 2: 60.5 min (range, 30-163 min)], and cardiopulmonary bypass time [group 1: 57 min (range, 22-150 min); group 2: 90 min (range, 39-388 min)]. There were also significant differences in favor of group 1 in terms of postoperative need for inotropic support [group 1: 26 patients (16%); group 2: 68 patients (35%)]. Although there were no statistically significant differences in the groups in terms of mortality rates according to the Parsonnet scoring system, with the exception of the moderate risk group, it was noted that the mortality rates in the beating heart group were lower.
  
  
  CONCLUSIONS
  This study concluded that beating heart MVS can be performed successfully, particularly for patients at higher risk which will lead to increased morbidity and mortality in postoperative period.
authors.affiliation: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Sihhiye, 06100 Ankara, Turkey.
authors.forename: Seyhan
authors.initials: S
authors.lastname: Babaroglu
authors.forename: Kerem
authors.initials: K
authors.lastname: Yay
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Parlar
authors.forename: Can
authors.initials: C
authors.lastname: Ates
authors.forename: Ufuk
authors.initials: U
authors.lastname: Mungan
authors.forename: Ferit
authors.initials: F
authors.lastname: Cicekcioglu
authors.forename: Ufuk
authors.initials: U
authors.lastname: Tutun
authors.forename: Salih Fehmi
authors.initials: SF
authors.lastname: Katircioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000401:mortality; D002316:Cardiotonic Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003422:Critical Care; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D018579:Patient Selection; D010477:Perfusion; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D056346:Sternotomy; D013908:Thoracotomy; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D002316:Cardiotonic Agents