A Superior-Septal Approach for Mitral Valve Repair-Experience from Eight Cases

Hou-Sheng Yang ； Shih-Hurng Loh ； Chung-Yi Chang ； Gou-Jieng Hong ； Kou-Chen Lee ； Yi-Ting Tsai ； Chih-Yuan Lin ； Chien-Sung Tsai

《Journal of Medical Sciences》 25卷1期 (2005/02) Pp. 33-36

並列摘要

Background: Satisfactory exposure of the mitral apparatus is a prerequisite for accurate repair of the mitral valve. The technique of cardiectomy used for transplant recipients can be modified to improve exposure of the mitral valve for patients with difficult anatomical access. Methods: Eight patients (5 men, 3 women) were treated with the superior-septal approach for mitral valve repair from December 2000 to August 2001: ages ranged from 20 to 75 years. Three patients received both mitral valve repair (MVR) and tricuspid valve annuloplasty (TVA). Follow-up periods ranged from 1 to 27 months. Results: One case was complicated by postoperative bleeding, which necessitated reopening surgery. Seven of the patients who had a normal sinus rhythm preoperatively remained in normal sinus rhythm at a late follow-up stage. One patient died as the result of spontaneous subdural hematomas, subarachnoid hemorrhage and delayed intracranial hemorrhage, about 1 month after MVR and TVA. All other patients survived without any late complications. Conclusions: The septal-superior (transplant) approach to MVR provides good surgical exposure of the mitral valve and the subvalvular apparatus. This limited series does not allow definitive conclusions to be drawn on the effects of this approach on postoperative cardiac rhythm. However, there appear to be no significant effects on postoperative heart rhythm, and late follow-up results appear acceptable.

並列關鍵字

mitral valve repair ； superior septal approach ； valvular heart disease