Document Detail

Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
MedLine Citation:
PMID:  21103739     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The right anterolateral thoracotomy is an alternative technique for surgical approach of mitral valve. In these cases, femoral-femoral bypass still has been used, rising occurrence of complications related to femoral cannulation.
OBJECTIVE: Describe the technique and results of mitral valve treatment by right anterolateral thoracotomy using aortic cannulation for cardiac pulmonary bypass (CPB).
METHODS: From 1983 e 2008, 100 consecutive female patients, with average age 35 ±13 years, 96 (96%) underwent mitral valve surgical treatment in the Heart Institute of São Paulo. A right anterolateral thoracotomy approach associated with aortic cannulation was used for CPB. Eighty (80%) patients had rheumatic disease and 84 (84%) patients presented functional class III or IV.
RESULTS: Were performed 45 (45%) comissurotomies, 38 (38%) valve repairs, 7(7%) mitral valve replacements, seven (7%) recomissurotomies and three (3%) prosthesis replacement. Sparing surgery was performed in 90 (90%) patients. The average CPB and clamp time were 57 ± 27 min e 39 ± 19 min, respectively. There were no in-hospital death, reoperation due to bleeding and convertion to sternotomy. Introperative complications were related to heart harvest (5%), especially in reoperations (3%). The most important complications in postoperative period were related to pulmonary system (11%), followed by atrial fibrilation (10%) but without major systemic repercussions. The mean inhospital length of stay was 8 ± 3 days. Follow-up was 6.038 patients/month. Actuarial survival was 98.0 ± 1.9% and freedom from reoperation was 81.4 ± 7.8% in 180 months.
CONCLUSION: The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety.
Marco Antonio Vieira Guedes; Pablo Maria Alberto Pomerantzeff; Carlos Manuel de Almeida Brandão; Marcelo Luiz Campos Vieira; Max Grinberg; Noedir Antonio Groppo Stolf
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista brasileira de cirurgia cardiovascular : órgão oficial da Sociedade Brasileira de Cirurgia Cardiovascular     Volume:  25     ISSN:  1678-9741     ISO Abbreviation:  Rev Bras Cir Cardiovasc     Publication Date:    2010 Jul-Sep
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-04-06     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9104279     Medline TA:  Rev Bras Cir Cardiovasc     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  322-5     Citation Subset:  IM    
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MeSH Terms
Cardiac Catheterization / adverse effects,  methods*
Coronary Artery Bypass / adverse effects,  methods*
Extracorporeal Circulation
Follow-Up Studies
Length of Stay
Mitral Valve Insufficiency / surgery*
Severity of Illness Index
Thoracotomy / adverse effects,  methods*

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