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On‐Pump Beating Heart Mitral Valve Surgery without Cross‐Clamping the Aorta
Author(s) -
Katircioglu Salih Fehmi,
Cicekcioglu Ferit,
Tutun Ufuk,
Parlar Ali Ihsan,
Babaroglu Seyhan,
Mungan Ufuk,
Aksoyek Aysen
Publication year - 2008
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2008.00648.x
Subject(s) - medicine , cardiopulmonary bypass , perioperative , mitral valve , aorta , surgery , mitral valve repair , cardiology , intensive care unit , cardiac surgery , mitral valve replacement , ascending aorta , anesthesia
Abstract Background and Aim: Cardiac reperfusion injury is a well‐described complication occurring after ischemia or following cardioplegic arrest. Various strategies have been developed to prevent ischemic reperfusion injury. The aim of this study was to assess the efficacy and applicability of the on‐pump beating heart mitral valve surgery without cross‐clamping the aorta in order to prevent reperfusion injury. Methods: The prospective study (between April 2005 and December 2006) included 88 consecutive patients who underwent mitral valve surgery. The operations were carried out on a beating heart using normothermic cardiopulmonary bypass without cross‐clamping the aorta, therefore perfusing the heart antegradely through the aortic root. Venting the heart from the aorta and the pulmonary vein provided adequate visualization of the operative field. Results: Seventy‐eight patients (88.6%) underwent mitral valve replacement and 10 patients (11.3%) underwent mitral valve repair with this technique. Concomitant surgery was required in 29 patients (32.9%). Twenty‐five patients (28.4%) had also undergone previous open heart surgery. Mean cardiopulmonary bypass time was 57.4 ± 18.4 minutes. Mean duration of ventilation was 12.2 ± 3.5 hours, mean intensive care unit stay was 1.3 ± 1.6 days, and mean hospital stay was 6.9 ± 4.5 days. One‐year survival was 96.6% for all causes of mortality. Conclusions: In this study, we showed that on‐pump beating heart operations without cross‐clamping is an acceptable surgical choice for mitral valve disease. Complication rates are low and perioperative mortality is lower than that generally reported with conventional technique.