On-pump beating-heart mitral valve plasty without aortic cross-clamping |
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Authors: | Tomohiro Mizuno and Hirokuni Arai |
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Institution: | (1) Department of Cardiovascular Surgery, Machida Municipal Hospital, Department of Cardiovascular Surgery, Machida Municipal Hospital, 2-15-41 Asahi-Chou, Machida, Tokyo 194-0023, Japan;(2) Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan |
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Abstract: | Patients with ischemic cardiomyopathy often have mitral regurgitation, which should be corrected for better long-term survival.
Mitral valve surgery is usually performed during cardiopulmonary bypass under the arrested heart condition. The ascending
aorta is cross-clamped and the heart is arrested using a cardioplegic solution. However, because ischemic cardiomyopathy patients
often have a severely atherosclerotic ascending aorta and low cardiac function, aortic cross-clamping and cardiac arrest increase
the risk of postoperative thromboemboli and low cardiac output syndrome. Under the on-pump beating-heart condition, we performed
mitral valve plasty concomitant with coronary artery bypass grafting, tricuspid annuloplasty, left ventricular aneurysmectomy,
and the maze procedure without aortic cross-clamping for a patient with ischemic dilated cardiomyopathy and bradycardial atrial
fibrillation. The patient had no postoperative complications and recovered rapidly. Thus, to prevent serious postoperative
complications, on-pump beating-heart mitral valve surgery without aortic cross-clamping may be a suitable surgical option
for patients with ischemic cardiomyopathy. |
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Keywords: | Mitral regurgitation Mitral valve plasty On-pump beating heart |
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