Author/Editor		Geršak, Borut
Title		Mitral valve repair or replacement on the beating heart
Type		članek
Source		Heart Surg Forum
Vol. and No.		Letnik 3, št. 3
Publication year		2000
Volume		str. 232-7
Language		eng
Abstract		Background: Beating heart (oft-pump) coronary artery bypass grafting (CABG) techniques have led us to consider the possibility of performing mitral valve repairs and replacements (with or without CABG) on the beating heart. Methods: If CABG had to be performed in addition to the valve procedure, CABG was done first on the beating heart without cardiopulmonary bypass, it possible. For the valve procedure, the aorta was cross-clamped and the beating-heart status was maintained throughout the whole procedure with continuous, warm, oxygenated blood coronary-sinus perfusion. Results: We used this technique in 23 patienis with extremely low ejection fractions, 78*/, of whom were in New York Heart Association (NYHA) class 4 and 77% of whom were in New York Heart Association (NYHA) class 3. The procedures were: mitral-tricuspid (11 patients), mitralaortic (7 patients), mitral-tricuspid CABG (1 patient), and mitral-aortic CABG (4 patients). The total early mortality was 13% (3 of 23 patients). Two were in-hospital deaths. One patient with triple-vessel disease and acute mitral insufficiency (AMI) on intra aortic balloon pump had been operated on six days after AMl. The cause of death was systemic methicillin resistant staphyloccocus aureus infection. The other death was a female patienl who was operated on after previous multiple cerebrovascular infarctions (CVIs) (cause of the death was CVI). In addition, one patient died one month after the operation because of prosthetic valve endocarditis on aortic and mitral valves (silver-coated silzone aortic and mitral valves were implanted because of chronic latent asymptomatic tibial osteitis). None of these deaths were cardiac related. (Abstract truncated at 2000 characters)
Descriptors		MITRAL VALVE HEART VALVE PROSTHESIS CORONARY ARTERY BYPASS AORTIC VALVE TRICUSPID VALVE STROKE VOLUME CARDIAC OUTPUT, LOW