title: Myocardial protection during minimally invasive mitral valve surgery: strategies and cardioplegic solutions.
abstract: Effective myocardial protection and perfusion strategies during minimally invasive mitral valve surgery (Mini-MV) have evolved over the last decade. Our institutional approach for right-sided Mini-MV has been standardized over the last 15 years in more than 4,500 cases. Cardiopulmonary bypass (CPB) is usually instituted by right-sided femoral arterial and venous cannulation with additional cannulation of the right jugular vein in patients with a body weight greater than 75 kg or when a concomitant tricuspid valve (TV) procedure and/or atrial septal defect closure is performed. A single dosage of crystalloid-based cardioplegia [Custodial- histidine-trypthophan-ketoglutarate (Custodial-HTK)] administered via the aortic root in combination with moderate hypothermia (34-35 °C) has become the standard of care for induction and maintenance of myocardial protection at our institution. The present article highlights and discusses the principal techniques of myocardial protection for Mini-MV.
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Garbade
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Piroze
authors.initials: P
authors.lastname: Davierwala
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Seeburger
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Pfannmueller
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Misfeld
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Borger
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
authors.forename: Friedrich-Wilhelm
authors.initials: FW
authors.lastname: Mohr
keywords: Minimally invasive mitral valve surgery (Mini-MV); myocardial preservation and protection