BEATING HEART MITRAL VALVE REPLACEMENT. EXPERIENCE AT A TERTIARY CARE HOSPITAL

Objective: To study the early outcomes of mitral valve surgery performed with a beating heart and cardiopulmonary bypass. Study Design: Prospective descriptive study. Place and Duration of Study: Cardiac Surgery department, Rawalpindi Institute of Cardiology, Rawalpindi, from Aug 2017 to Aug 2019. Methodology: Consecutive patients requiring mitral valve surgery were included in the study. Those requiring multiple procedures, redo procedures and emergency procedures were excluded from the study. Data was collected on preformed proformas and perioperative variables were recorded. Patients were followed till discharge or 30 days after the surgery. Statistical Package for Social Sciences version 23.0 was used to analyse the data. Results: A total of 27 patients were included in the study, 21 (77.78%) female and 6 (22.2%) male patients. The mean age of the patients was 30.89 ± 10.8 years. Of the cohort, 4 (14.8%) had mitral stenosis, 16 (59.3%) had mitral regurgitation and mixed disease (both mitral stenosis and mitral regurgitation) was present in 7 (25.9%). The median pulmonary artery pressure (mPAP) was 34 mmHg. All the patients received mechanical mitral valve prosthesis, 27 (100%). A modified Devaga’s procedure for tricuspid valve repair was done in 4 (14.8%) patients. Most of the patients required only mild inotropic support, 22 (81.4%). Median intensive care unit stay was 24 hours with a mean of 33 ± 16 hours. All the patients were alive at the end of the early follow up. Conclusion: Beating heart mitral valve surgery on cardiopulmonary bypass is a feasible technique. It has acceptable early outcome in terms of mortality and major morbidity indicators.

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Combined Mitral and Aortic Valve Surgery: 17 Years’ Experience in a Single Center

Scandinavian Journal of Surgery ◽

10.1177/1457496920987427 ◽

2021 ◽

pp. 145749692098742

Author(s):

A. Husso ◽

T. Riekkinen ◽

A. Rissanen ◽

J. Ollila ◽

A. Valtola

Keyword(s):

Mitral Valve ◽

Aortic Valve ◽

Mitral Regurgitation ◽

Aortic Regurgitation ◽

Real Life ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Tricuspid Valve Repair ◽

Aortic Valve Surgery ◽

Single Center

Background and Aims: It is not uncommon that patients requiring valve surgery have several simultaneous valvular dysfunctions. Combined aortic and mitral valve surgery is the most common form of double-valve surgery. The aim of this study was to analyze and present the outcomes of simultaneous aortic and mitral valve surgery in a single center in a real-life setting. Materials and Methods: The study population consisted of 150 patients operated in the Kuopio University Hospital from 2004 to 2020. All patients undergoing concomitant mitral and aortic valve surgery were included. Four groups were formed based on either the etiology or pathophysiology of the valvular dysfunction. The most common combination was mitral regurgitation with aortic regurgitation ( n = 72, 48%), followed by mitral regurgitation with aortic stenosis ( n = 37, 25%), endocarditis ( n = 29, 19%), and mitral stenosis with aortic regurgitation or stenosis ( n = 12, 8%). Concomitant coronary artery revascularization was performed in 37 (25%) patients and tricuspid valve repair in 26 (17%) patients. Results: Operative mortality was 2% and 30-day mortality was 7%. Overall survival was 86%, 78%, and 61% in 3, 5, and 10 years, respectively. Patients with endocarditis were significantly more morbid, and more often than other patients had to undergo an emergency operation. There were no significant differences between the groups in terms of early and late survival. In the overall cohort, the EuroSCORE II value, increased pulmonary artery pressure, decreased glomerular filtration, and length of the operation displayed a negative correlation with survival. Conclusion: Despite the challenging nature of multivalvular heart disease, surgery is a safe method of treatment with good short- and long-term outcomes.

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