title: Extended vertical transseptal approach versus transseptal approach for mitral valve operation.
abstract: BACKGROUND
  Adequate exposure of the mitral valve is a critical factor of success for either replacement or repair of the mitral valve. In the present study, we evaluated the merits of the extended vertical transseptal approach in comparison with the transseptal approach for mitral valve operations.
  
  
  METHODS
  A total of 72 consecutive patients operated on for mitral procedures were allocated to either group A (those operated on through an extended vertical transseptal approach [n = 38]) or group B (whose mitral valve exposure was achieved through a right atrium transseptal approach [n = 34]). The operation time, aortic cross-clamp time, first 24-hour drainage volume after the operation, and the rhythms pre- and postsurgery were compared between the 2 groups.
  
  
  RESULTS
  The mean operation time and mean cross-clamp time in group A were longer than that in group B and the drainage volume was greater in the first 24 hours, but the differences were not statistically significant. There was no surgical reexploration for bleeding in either group. For the 13 patients who had normal sinus rhythm preoperatively in group A, 2 (15.4%) developed episodes of atrial fibrillation and 1 (7.7%) developed temporary sinus bradycardia requiring temporary pacing in the immediate and early postoperative period. In group B, 2(15.4%) of patients with normal sinus rhythm before surgery developed atrial fibrillation that continued until 1 week after surgery.
  
  
  CONCLUSIONS
  The extended vertical transseptal approach not only affords excellent exposure of the mitral valve, but also is safe for maintaining sinus node function compared with the transseptal approach.
authors.affiliation: Department of Cardio-Thoracic Surgery, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi Province, P. R. China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Cardio-Thoracic Surgery, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi Province, P. R. China.
authors.forename: Xianqiu
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Cardio-Thoracic Surgery, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi Province, P. R. China.
authors.forename: Wuli
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Cardio-Thoracic Surgery, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi Province, P. R. China.
authors.forename: Minfeng
authors.initials: M
authors.lastname: Xiang
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006346:Heart Septum / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult