Mitral Valve Operation in Dextrocardia

Objective The effects and benefits of a transaortic endoclamp for mitral valve operation through right minithoracotomy have not been established. Methods The records were examined in 671 patients undergoing mitral valve operation using aortic cannulation through a 6-cm right minithoracotomy in the fourth intercostal space. The ascending aorta was cannulated with a 24-Fr cannula through a 12-mm port in the first intercostal space. The experience from 1998 to 2006 with aortic endoclamping (group A, N = 436) was compared with the experience from 2006 to 2009 with external aortic clamping (group B, N = 235). Aortic endoclamping was achieved with a 30 mL endoclamp introduced through the aortic cannula into the ascending aorta to provide aortic endoclamping, anterograde cardioplegia, and root venting. Percutaneous femoral venous cannulation was used. Results Group A and group B had similar demographics. Endoclamp availability (group A) resulted in significantly less fibrillatory arrest (no clamping) in 67 of 436 (15%) versus 104 of 235 (44%) patients in group B (P = 0.001). In patients with aortic clamping, endoclamp (group A) versus external clamp (group B) was not a determinant of clamp time or pump time. Hospital and late outcomes were not different between groups. No patient complications could be attributed to the endoclamp. Conclusions Aortic endoclamping requires no more clamp or pump time than external clamping and can provide a more bloodless field than ventricular fibrillation without obstructing hardware. Aortic endoclamping is a safe alternative for mitral surgery through right minithoracotomy.

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Results of coronary artery bypass grafting and/or aortic or mitral valve operation in patients ≥90 years of age

The American Journal of Cardiology ◽

10.1016/0002-9149(94)90599-1 ◽

1994 ◽

Vol 74 (9) ◽

pp. 960-962 ◽

Cited By ~ 26

Author(s):

Tsung Po Tsai ◽

Timothy A. Denton ◽

Aurelio Chaux ◽

Jack M. Matloff ◽

Robert M. Kass ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Mitral Valve ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Mitral Valve Operation ◽

Valve Operation

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Mitral valve re-repair vs replacement following failed initial repair: a systematic review and meta-analysis

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01344-3 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Muthu Veerappan ◽

Prashasth Cheekoty ◽

Faizus Sazzad ◽

Theo Kofidis

Keyword(s):

Mitral Valve ◽

Clinical Outcomes ◽

Mitral Valve Repair ◽

Operative Mortality ◽

Meta Analysis ◽

Valve Repair ◽

Operative Outcomes ◽

Mitral Valve Operation ◽

Retrospective Cohort Studies ◽

Valve Operation

Abstract Background The optimal treatment strategy following a failed mitral valve repair remains unclear. This study aims to compare and analyse available studies which report the clinical outcomes post mitral valve re-repair (MVr) or replacement (MVR) after a prior mitral valve repair. Methods Based on PRISMA guidelines, a literature search was performed utilising PubMed, Cochrane and Scopus databases to identify retrospective cohort studies that reported outcomes of MVr and MVR after a prior mitral valve repair. Data regarding operative mortality, clinical outcomes and complications were extracted, synthesized and meta-analysed where appropriate. Results Eight studies with a total cohort of 1632 patients were used. After analysis, no significant differences in the short term and long-term operative mortality, incidence of stroke, congestive heart failure, Grade 1 and Grade 2 mitral regurgitation, requirement of 3rd mitral valve operation and reoperation due bleeding were found between the two groups. However, a slightly higher incidence of postoperative atrial fibrillation (OR: 0.11, CI: 0.02 to 0.17, I2 = 0%, p = 0.02) was observed in the MVR group, as compared to the MVr group. Conclusion MVr appears to be a viable alternative to MVR for mitral valve reoperation, given that they are associated with similar post-operative outcomes.

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