| Beating-heart mitral valve surgery in patients with poor left ventricular function. | |
| | |
MedLine Citation:
|
PMID: 15311869 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND AIM OF THE STUDY: Mitral valve surgery in the presence of poor left ventricular (LV) function is associated with higher mortality. One surgeon's (S. K. N.) evolving practice of mitral valve surgery on the beating heart using normothermic cardiopulmonary bypass (CPB) in a cohort of patients is described. METHODS: Between July 2000 and December 2002, 23 patients (13 men, 10 women; mean age 68.6 +/- 4.8 years; range: 54-81 years) with mitral regurgitation and LV ejection fraction <30% undergoing isolated mitral valve repair (n = 4) or replacement (n = 19) were investigated. All patients received maximal drug therapy. Among patients, 17 were in NYHA class III, and six in class IV. RESULTS: The mean duration of follow up was 17 +/- 14 months, and was complete for all survivors. The visual field of the on-pump beating heart was equal to that of conventional valvular surgery, and technical accuracy was not compromised. The mean ICU and hospital stays were 2.4 +/- 1.3 days and 8.9 +/- 2.6 days, respectively. Mean CPB time was 74.3 +/- 14.8 min. Thirty-day mortality was significantly lower (8.7%) when compared to mean Euroscore-predicted mortality for this high-risk group (16.9%; p <0.001). The medium-term one- and two-year survivals were 87% and 78%, respectively. Mean NYHA class was improved, from 3.6 +/- 0.5 preoperatively to 1.9 +/- 0.7 at follow up (p = 0.037). CONCLUSION: On-pump, beating-heart mitral valve surgery is a good option in patients with poor LV function, and is advantageous as conditions for the heart are more physiological with a beating tonus than with cardioplegia. |
| | |
Authors:
|
Sudip Ghosh; Rajwinder S Jutley; Philip Wraighte; Matloubb Shajar; Surendra K Naik |
Related Documents
:
|
6730719 - The modified ombredanne repair for hypospadias--a comparison of single-stage and multi-... 8431039 - Atrioventricular canal defect: two-patch repair and tricuspidization of the mitral valve. 9879869 - Is a prosthetic ring required for mitral repair of mitral insufficiency due to posterio... 9359549 - Fate of mitral regurgitation following repair of atrioventricular septal defect. 7300399 - Long-term results of repair of incomplete persistent atrioventricular canal. 7872179 - Immediate and late outcome of percutaneous balloon mitral valvotomy in patients with si... 15152959 - Diagnosis and treatment of acne. 15821659 - Determining the best procedure for radial artery harvest: prospective randomized trial ... 23622449 - Surgical results after one-muscle recession for correction of horizontal sensory strabi... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of heart valve disease Volume: 13 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 2004 Jul |
Date Detail:
|
Created Date: 2004-08-17 Completed Date: 2004-11-06 Revised Date: 2006-05-04 |
Medline Journal Info:
|
Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: England |
Other Details:
|
Languages: eng Pagination: 622-7; discussion 627-9 Citation Subset: IM |
Affiliation:
|
Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield, UK. sudip.ghosh@talk21.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Cardiopulmonary Bypass Combined Modality Therapy Coronary Artery Bypass Female Follow-Up Studies Great Britain Heart Valve Prosthesis Implantation* Humans Length of Stay Male Middle Aged Mitral Valve / physiopathology, surgery* Mitral Valve Insufficiency / mortality, physiopathology, surgery* Postoperative Complications / etiology, mortality, physiopathology Stroke Volume / physiology Survival Analysis Time Factors Treatment Outcome Ventricular Dysfunction, Left / mortality, physiopathology, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effect of mitral valve repair/replacement surgery on atrial arrhythmia behavior.
Next Document: Tear in mitral anterior leaflet as a complication of Manouguian's procedure in a woman with an aorti...