Beating Heart Mitral Valve Replacement in Patients with Chronic Severe Mitral Regurgitation and Left Ventricular Dysfunction
- #AC/VAL 02-O-6
- Adult Cardiac Surgery/Valves. SESSION-2
- Oral
Beating Heart Mitral Valve Replacement in Patients with Chronic Severe Mitral Regurgitation and Left Ventricular Dysfunction
Hosam F. Fawzy 1, Ahmed Elshemy 2, Elatafy Elatafy 1, Ehab Wahby 1, Sameh Alamin 2, Amr Fawzy 3
1 Faculty of Medicine, University of Tanta, Tanta, Egypt; 2 National Heart Institue, Cairo, Egypt; 3 Faculty of Medicine, University of Cairo, Cairo, Egypt;
Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–B
Abstract
OBJECTIVE:
Global myocardial ischemia and reperfusion injury following cardioplegic arrest are well-described complications occurring after open heart surgery. The aim of this study was to assess the efficacy and safety of the on-pump beating heart mitral valve replacement (MVR) in patients with chronic severe mitral regurgitation and left ventricular dysfunction.
METHODS:
Sixty patients scheduled for mitral valve replacement,were randomly assigned into two groups. Group I: 30 patients underwent MVR using the conventional technique. Group II: 30 patients underwent beating heart MVRusing normothermic cardiopulmonary bypass wherethe aorta and both vena cavae were cannulated in the usual fashion. Right superior pulmonary vein and pulmonary artery vents were inserted to provide adequate visualization of the operative field. A two way cannula was inserted into the aortic root; one channel was connected to the arterial line for coronary perfusion while the second was kept at low suction throughout the operation for de-airing.
RESULTS:
Preoperative parameters were comparable in the two groups. Group I had a significant shorter mitral surgical time (28 ± 4.5 min in group I vs. 44.5 ± 9.5 min in group II; P< 0.001). However, there was no significant difference between the two groups in terms of total bypass time (P= 0.441). Group II had a significant less postoperative need for inotropic support (group I: 13 patients; group II: 3 patients; P< 0.001). Group II also had a significant shorter ICU stay (group I: 3.6 ± 1.1 days; group II: 2.4 ± 0.68 days; P=0.049). However, there was no significant difference in hospital stay (P< 0.244). There was no mortality in both groups.
CONCLUSIONS:
Beating heart mitral valve replacement is a safe, efficient and applicable surgical choice particularly in high risk patients withleft ventricular dysfunction.