Logo image
Back
Multiple valve surgery with beating heart technique
Journal article   Open access   Peer reviewed

Multiple valve surgery with beating heart technique

Marco Ricci, Francisco Igor B Macedo, Maria R Suarez, Michael Brown, Julia Alba and Tomas A Salerno
The Annals of thoracic surgery, Vol.87(2), pp.527-531
02/2009
DOI: 10.1016/j.athoracsur.2008.10.030
PMID: 19161773
url
https://doi.org/10.1016/j.athoracsur.2008.10.030View
Published (Version of record) Open Access

Abstract

Multiple valve surgery was performed utilizing beating heart technique through simultaneous antegrade/retrograde perfusion with blood. We herein report our experience with this technique in patients with multiple valve disease processes. Of 520 consecutive patients operated upon utilizing this method between 2000 and 2007, 59 patients underwent multiple valve surgery. Mean age was 54.2 +/- 13.8 years (range, 21 to 83) with 41 males (69.5%) and 18 females (30.5%). Double-valve and triple-valve operations were performed in 54 and 5 patients, respectively. Of 32 mitral valve replacements, there were 30 biological (93.8%) and 2 mechanical (6.2%) mitral valves. Aortic valve replacement was performed in 25 patients: 22 (88%) with biological and 3 (12%) with mechanical prostheses. Two patients had mitral and tricuspid valve repair. The most common procedure was mitral valve replacement plus tricuspid valve repair (16 patients; 27.1%), mitral valve replacement plus aortic replacement (14 patients; 23.7%), and mitral valve repair plus tricuspid repair (13 patients; 22%). Concomitant coronary artery bypass grafting was performed in 7 (11.8%) of 59 patients. Mean hospital stay was 25.6 +/- 29.6 days (range, 3 to 195; median, 17). Early mortality (less than 30 days) occurred in 5 patients (8.4%), and late mortality (more than 30 days) occurred in 2 patients (3.4%). Reoperation for bleeding was needed in 5 patients (8.4%). Intra-aortic balloon pump was required preoperatively and postoperatively in 4 and 1 patients, respectively. Clinical and echocardiographic follow-up in 33 patients at 11.8 +/- 16.4 months (range, 1 to 80) showed preserved postoperative left ventricular ejection fraction. Three patients had perivalvular leaks on follow-up but required no surgery. Nineteen patients were lost to follow-up. This study demonstrates the feasibility and safety of beating heart techniques in multiple valve operations. Further studies are needed to fully evaluate the potential benefits of this method of myocardial perfusion as a means to eliminate ischemia-reperfusion injury, and to preserve ventricular function in multiple valvular surgery.
 Follow-Up Studies Humans Middle Aged Bioprosthesis Male Mitral Valve - surgery Heart Valve Diseases - surgery Aortic Valve - surgery Young Adult Aged, 80 and over Heart Valve Diseases - mortality Adult Female Heart Valve Diseases - diagnosis Retrospective Studies Risk Assessment Heart Valve Prosthesis Heart Valve Prosthesis Implantation - methods Heart Valve Prosthesis Implantation - mortality Treatment Outcome Cardiopulmonary Bypass - methods Survival Analysis Aged Coronary Artery Bypass, Off-Pump Cohort Studies

Details

Metrics

22 Record Views
32 Times Cited - Web of Science
Logo image