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Sinus node function after mitral valve surgery using the superior septal approach.

H Shin1, R Yozu, S Higashi

  • 1Division of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan. h-shin@med.keio.ac.jp

The Annals of Thoracic Surgery
|March 10, 2001
PubMed
Summary
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The superior septal approach (SSA) for mitral valve surgery generally preserves sinus node function long-term. While temporary arrhythmias can occur post-surgery, the SSA does not seem to cause lasting harm to sinus node function.

Area of Science:

  • Cardiovascular Surgery
  • Electrophysiology
  • Cardiac Rhythm Management

Background:

  • The impact of the superior septal approach (SSA) on sinus node function during mitral valve surgery remains debated.
  • Assessing sinus node function post-SSA is crucial for understanding potential long-term cardiac rhythm implications.

Purpose of the Study:

  • To evaluate sinus node function following mitral valve surgery using the superior septal approach (SSA).
  • To determine if the SSA leads to significant or lasting adverse effects on sinus node function.

Main Methods:

  • Conducted electrophysiological examinations and electrocardiographic monitoring in 46 patients undergoing mitral valve surgery via SSA.
  • Preoperative rhythm included atrial fibrillation (AF) and sinus rhythm (SR); 13 patients with no preoperative dysfunction underwent postoperative electrophysiological studies.

Related Experiment Videos

  • Monitored cardiac rhythm perioperatively and long-term using portable and standard electrocardiography.

    • Main Results:

    • Early postoperative supraventricular arrhythmias occurred in 12/20 patients with SR, but all resolved spontaneously.
    • Electrophysiological studies showed no sinus node dysfunction (e.g., basic cycle length, sinoatrial conduction time, sinus node recovery time).
    • Long-term follow-up (34 ± 24 months) revealed 2/20 SR patients developed persistent AF, while 3/25 AF patients converted to SR.

    Conclusions:

    • The superior septal approach (SSA) for mitral valve surgery does not appear to induce long-term sinus node dysfunction.
    • Temporary cardiac rhythm disturbances may occur post-SSA, but these typically resolve without persistent adverse effects on sinus node function.