Document Detail

Conventional left atrial versus superior septal approach for mitral valve replacement.
MedLine Citation:
PMID:  9124917     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study was designed to evaluate the safety and effectiveness of the superior septal approach for routine mitral valve replacement. METHODS: One hundred forty-six consecutive patients undergoing mitral valve replacement at our institution were randomly assigned to undergo the procedure using either the conventional left atriotomy or the superior septal approach. Postoperatively and during the follow-up, 12-lead electrocardiography, 24-hour Holter monitoring, and transthoracic and transesophageal echocardiography were performed in all patients. RESULTS: The cardiopulmonary bypass and cross-clamp times were significantly higher in the superior septal group. No significant difference in blood loss was found between the two groups, and no residual atrial septal defect was found in patients in whom we used the superior septal approach. The maintainance of sinus rhythm at late follow-up and the incidences of postoperative arrhythmias and newly developed atrioventricular block were not significantly different between the two groups. CONCLUSIONS: The use of the superior septal approach to the mitral valve is not associated with a greater incidence of rhythm disturbances or other complications. Because this approach provides optimal exposure of the valve and the subvalvular apparatus, it has been routinely adopted for use in patients undergoing mitral valve replacement at our institution.
M Gaudino; F Alessandrini; F Glieca; L Martinelli; P Santarelli; P Bruno; G Possati
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  63     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-04-22     Completed Date:  1997-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1123-7     Citation Subset:  AIM; IM    
Department of Cardiac Surgery, Catholic University, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Cardiopulmonary Bypass / methods
Cause of Death
Follow-Up Studies
Heart Atria / surgery
Heart Septum / surgery
Hospital Mortality
Middle Aged
Mitral Valve / surgery*
Postoperative Hemorrhage / surgery
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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