Journal article
Concomitant Beating-Heart Mitral Valve Surgery and Coronary Artery Bypass in Patients With Compromised Ventricular Function
Innovations (Philadelphia, Pa.), Vol.1(4), pp.151-154
06/01/2006
DOI: 10.1097/01.imi.0000218578.04748.9c
PMID: 22436675
Abstract
Background: Surgical repair of mitral valve disease and concomitant coronary artery occlusive disease has high operative risk. Myocardial protection for protracted, complicated procedures is seminal to the overall operative outcome; specifically, preservation of left ventricular function.
Methods: The authors conducted a retrospective review of 25 patients undergoing combined mitral valve repair/replacement (MVR) and coronary artery bypass surgery (CABG) using the beating-heart technique at the Miller/University of Miami School of Medicine. The CABG was performed without cardiopulmonary bypass support. During the mitral valve surgery the perfusion pressure was maintained at 80-90 mm Hg and the systemic temperature at 35-36 degrees C. The aorta was not cross-clamped.
Results: Twenty-five patients underwent MVR/CABG, including 7 patients with acute myocardial infarction. Preoperative echocardiograms revealed a mean ejection fraction (EF) of 41 +/- 4.5%. One patient required a preoperative intraarterial balloon pump. An average of 2.12 +/- 0.9 grafts and a total of 10 mitral valve repairs were performed. The average length of stay in the intensive care unit was 14 +/- 1.8 days, and average hospitalization time was 23 +/- 3. The mean postoperative EF was 41 +/- 4.5%. The mortality in this patient group was 12 % (3/25) with a morbidity rate of 52% (13/25).
Conclusions: The data suggest that the technique is safe and reproducible, and that it potentially has a short-term benefit on left ventricular function. Therefore, this particular technique may be efficacious in patients with compromised left ventricular function requiring a combined MVR/CABG.
Details
- Title: Subtitle
- Concomitant Beating-Heart Mitral Valve Surgery and Coronary Artery Bypass in Patients With Compromised Ventricular Function
- Creators
- Gabriele Di Luozzo - University of MiamiPierluca Lombardi - University of MiamiAlberto Maldonado - University of MiamiMarco Ricci - University of MiamiTomas A. Salerno - University of Miami
- Resource Type
- Journal article
- Publication Details
- Innovations (Philadelphia, Pa.), Vol.1(4), pp.151-154
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/01.imi.0000218578.04748.9c
- PMID
- 22436675
- ISSN
- 1556-9845
- eISSN
- 1559-0879
- Number of pages
- 4
- Language
- English
- Date published
- 06/01/2006
- Academic Unit
- Cardiothoracic Surgery
- Record Identifier
- 9984322885202771
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