scholarly journals Beating-heart versus conventional mitral valve replacement; a randomized clinical trial

2020 ◽  
Author(s):  
Abd-Allah Badr ◽  
Essam Yousef ◽  
Mostafa Kotb ◽  
Ahmed Deebis
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Troponin I ◽  
Conventional Technique ◽  
Beating Heart ◽  
Control Group ◽  
Coronary Perfusion ◽  
Significant Difference ◽  
Heart Group

Background: Various methods have been developed to overcome the deleterious effects of ischemia/ reperfusion injury that occurs after cardioplegic arrest. The aim of the study was to assess the safety, efficacy, and applicability of the beating-heart mitral valve replacement (MVR) compared to the conventional MVR. Methods: Forty patients scheduled for mitral valve replacement were randomly assigned into two groups, conventional MVR as the control group (n= 20) and beating-heart MVR with continuous antegrade coronary perfusion as the study group (n=20). Three patients in the beating-heart group were converted to the conventional technique because of the blood-flooded field and excluded from the analysis. Results: The preoperative clinical and echocardiographic variables were comparable between both groups. There was no significant difference between both groups regarding cardiopulmonary bypass time (79.4± 14 vs. 75.7± 10.9 minutes; p= 0.398) and total operative time (200± 55.6 vs. 183.9± 67.5 min; p= 0.458) in the conventional and beating-heart group, respectively. Serum troponin I level was significantly higher in the conventional MVR group 6 hours postoperatively (4.9±4 vs. 2.7±1.2 ng/ml; p= 0.036), while there was no significant difference between both groups regarding total CK and CK-MB (p= 0.565 & 0.597 respectively).  Eight patients (44%) in the conventional MVR group needed inotropic support compared to 3 patients (19%) in the beating-heart MVR group (P = 0.11). There was no operative mortality or major morbidity in both groups. At 6-months follow-up, there was no difference in NYHA class (1.3±0.3 vs. 1.2±0.3; p= 0.336) and the ejection fraction (60.0±6.3 vs. 63.2±6 %; p= 0.139) in the conventional vs. beating-heart group.  Conclusion: Beating-heart MVR is a safe alternative to the conventional method with comparable outcomes. There is a relatively blood-filled field compared to the conventional technique.

scholarly journals Role of per-operative milrinone on pulmonary hypertension having mitral valve replacement.

2021 ◽  
Vol 28 (01) ◽  
pp. 120-124
Author(s):  
Shahbaz Ahmad Khilji ◽  
Shuja Tahir ◽  
Shahid Abbas
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Nyha Class ◽  
Control Group ◽  
Study Group ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

Objective: To determine the role of perioperative milrinone on pulmonary hypertension in patients with mitral valve disease undergoing mitral valve replacement surgery. Study Design: Randomized Control Trial. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad. Period: June 2019 to June 2020. Material & Methods: A total of 80 patients with mitral valve disease who underwent mitral valve replacement were included. The patients were divided into a control group of 40, who were not administered milrinone, and a study group of 40 who received milrinone perioperatively. TVPG, LVEF and NYHA class were recorded preoperatively and postoperatively and were compared. Results: In the study group, postoperative LVEFs and NYHA class were not statistically significant in both groups while postoperative TVPG was significantly lower in study group as compare to control group and is statistically significant (P<0.001). Conclusion: Our study concludes that milrinone can be used as an effective therapy to reduce pulmonary pressure in patients with pulmonary hypertension undergoing mitral valve replacement surgery.

Mitral valve replacement on a beating heart

2004 ◽  
Vol 20 (1) ◽  
pp. 30-30
Author(s):  
HS Bedi ◽  
RP Singh ◽  
V Goel ◽  
P Lal
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Beating Heart

Mitral Valve Replacement with the Beating Heart Technique in a Patient with Previous Bypass Graft from Ascending to Descending Aorta due to Aortic Coarctation

2008 ◽  
Vol 23 (2) ◽  
pp. 156-158 ◽  
Author(s):  
Ferit Cicekcioglu ◽  
A. Ihsan Parlar ◽  
Aysen Aksoyek ◽  
Seyhan Babaroglu ◽  
Kerem Yay ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Aortic Coarctation ◽  
Bypass Graft ◽  
Beating Heart ◽  
Descending Aorta

Beating heart mitral valve replacement in a patient with a previous Bentall operation

2008 ◽  
Vol 56 (5) ◽  
pp. 226-228 ◽  
Author(s):  
Ferit Cicekcioglu ◽  
Ali Ihsan Parlar ◽  
Levent Altinay ◽  
Alaa Hijazi ◽  
Ahmet Kuddusi Irdem ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Beating Heart ◽  
Bentall Operation

scholarly journals Creation of artificial chords during mitral valve replacement in patients with rheumatic heart disease

2012 ◽  
Vol 93 (3) ◽  
pp. 479-484
Author(s):  
I V Abdul’yanov ◽  
M N Mukharyamov ◽  
R K Dzhordzhikiya ◽  
I I Vagizov
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Contractile Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Left Ventricular Geometry ◽  
Control Group ◽  
Ventricular Ejection Fraction

Aim. To evaluate the effectiveness and safety of the use of artificial chords using polytetrafluoroethylene sutures during mitral valve replacement in patients with rheumatism. Methods. The study included 134 patients operated on for isolated rheumatic mitral valve disease. Immediate (10 days) and long-term (24 months) results were evaluated in the three groups of patients, depending on the method of valve replacement: creation of prosthetic chords using polytetrafluoroethylene sutures (37 patients), preservation of native chords (67 patients), total excision of the subvalvular apparatus (control group, 30 patients). Results. 24 months after surgery in the group of prosthetic chords and the group of preserved native chords recorded was a significant decrease in the pulmonary artery pressure, the left atrial size and a reduction in the end-diastolic left ventricular size. In the control group of patients reported was a reduction in left ventricular ejection fraction in long-term follow up. Conclusion. The use of polytetrafluoroethylene sutures in order to create new chords demonstrated their safety and effectiveness in preserving the physiological left ventricular geometry; artificial chords, as well as the preserved native chords, have a positive effect on the left ventricular contractile function in the remote postoperative period.

scholarly journals Evaluation of the preoperative administration of sildenafil on operative and early postoperative outcome after mitral valve replacement in patients with pulmonary hypertension

2020 ◽  
Author(s):  
Islam M Ibrahim ◽  
Ahmed L Dokhan ◽  
Rasha S Elsebaey ◽  
Mohammed G Abdellatif
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Pulmonary Artery ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Systolic Pulmonary Artery Pressure ◽  
Preoperative Administration ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Mitral valve diseases are commonly associated with pulmonary hypertension. The aim of this study was to evaluate the effect of preoperative administration of sildenafil on the outcome after mitral valve replacement in patients with pulmonary hypertension. Methods: This prospective randomized study was carried out on 67 patients who had a mitral valve replacement and associated high systolic pulmonary artery pressure more than 50 mmHg. Patients were randomized into three groups: group A (n= 20) received preoperative sildenafil for one week, group B (n=22) received sildenafil for one month, and group C (n= 25) did not receive sildenafil. All patients had transthoracic echocardiography preoperatively, one week and one month postoperatively. Results: There was no difference in preoperative and operative variables among groups. Dobutamine support was required in 15 patients (60%) in group C vs. 6 patients (30%) in group A and 5 patients (22.5%) in group B (p= 0.012). Duration of mechanical ventilation was significantly longer in group C (389.2 ± 48.79 minutes) compared to group A and B (295.5 ± 17.01 and 281.4 ± 39.44 minutes, respectively, p<0.001). ICU stay was longer in group C (61.72 ± 13.69 hours) compared to groups A and B (53.55 ± 14.49 and 45.64 ± 13.43 hours, respectively, p=0001). The hospital stay was longer in group C (8.0 ± 1.80 days) compared to group A and B (6.05 ± 0.94 and 6.27 ± 1.24 days, respectively; p< 0.001). The transthoracic echocardiographic study one month after the operation showed that pulmonary artery systolic pressure significantly lower in groups A and B (28.30 ± 3.3 and 28.2 ± 4.98 mmHg, respectively) compared to group C (43.12 ± 4.99 mmHg) (p <0.001). There was no statistically significant difference between groups A and B regarding PASP after five days  (p= 0.287) or one month (p= 0.939). Conclusion: We found that preoperative administration of oral sildenafil in patients with pulmonary hypertension undergoing mitral valve replacement may reduce pulmonary hypertension postoperatively. We could not find a difference in the administration of sildenafil for either one week or one month preoperatively.

Mitral Valve Replacements Under On-Pump Beating Heart and Lung Perfusion/Ventilation Using a Minithoracotomy: An Experience with 11 Cases

2012 ◽  
Vol 15 (3) ◽  
pp. 133
Author(s):  
Ansheng Mo ◽  
Zhaoke Wen ◽  
Hui Lin ◽  
Changchao Lu ◽  
Shengjin Liang
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Vena Cava ◽  
Ascending Aorta ◽  
Beating Heart ◽  
Arterial Cannulation ◽  
The Mean ◽  
The Impact

<p><b>Background:</b> The primary aims of minimally-invasive cardiac valve surgery are to lessen the impact of the incision, extracorporeal circulation, myocardial ischemia, and pulmonary ischemia, to obtain satisfactory therapeutic results, and to allow a quicker rehabilitation. In this study, the feasibility of minimally-invasive mitral valve replacements without ascending aorta and vena cava cross-clamping under beating heart was evaluated by surveying 11 patients.</p><p><b>Methods:</b> Preoperative risk factors, intraoperative techniques, and postoperative complications were surveyed and evaluated for one year (April 1, 2009 to March 30, 2010) in 11 patients who had undergone beating-heart mitral valve replacement surgery at The People's Hospital of Guangxi Zhuang Autonomous Region. Minithoracotomy and femoral arterial cannulation procedures were used in the surgeries for cardiopulmonary bypass (CPB) without ascending aorta and vena cava cross-clamping.</p><p><b>Results:</b> The operations were performed successfully in all 11 patients. The CPB time was 52.80 � 11.36 minutes; the mean postoperative mechanical ventilation assistance time was 8.20 � 2.84 hours; and the mean transfusion volume of red cells was 2.20 � 1.04 units. There were no cerebral complications, no periprosthetic leakage, no occurrence of permanent high-degree atrioventricular blockage, and no mortality.</p><p><b>Conclusion:</b> Mitral valve replacement on the beating heart using a minithoracotomy and femoral arterial cannulation for CPB without ascending aorta and vena cava crossclamping under pulmonary ventilation is feasible. A larger number of patients are required to further characterize the efficacy and safety of this procedure.</p>

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