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Related Experiment Videos

Beating-heart mitral valve surgery in patients with poor left ventricular function.

Sudip Ghosh1, Rajwinder S Jutley, Philip Wraighte

  • 1Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield, UK. sudip.ghosh@talk21.com

The Journal of Heart Valve Disease
|August 18, 2004
PubMed
Summary

On-pump, beating-heart mitral valve surgery offers a safer alternative for patients with poor left ventricular function. This technique demonstrated lower mortality and improved functional class compared to predicted outcomes.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Minimally Invasive Cardiac Surgery

Background:

  • Mitral valve surgery in patients with poor left ventricular (LV) function carries a high mortality risk.
  • This study describes an evolving surgical practice for mitral valve procedures on a beating heart.

Purpose of the Study:

  • To evaluate the safety and efficacy of on-pump, beating-heart mitral valve surgery in patients with severely impaired LV function (ejection fraction <30%).

Main Methods:

  • A cohort of 23 patients with mitral regurgitation and LV ejection fraction <30% underwent isolated mitral valve repair or replacement.
  • All patients received maximal medical therapy and underwent surgery on a beating heart using normothermic cardiopulmonary bypass (CPB).

Main Results:

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  • Thirty-day mortality was significantly lower (8.7%) than predicted (16.9%; p <0.001).
  • Mean ICU and hospital stays were short (2.4 and 8.9 days, respectively).
  • One- and two-year survival rates were 87% and 78%, with significant improvement in NYHA class (3.6 to 1.9; p = 0.037).

Conclusions:

  • On-pump, beating-heart mitral valve surgery is a viable and advantageous option for patients with poor LV function.
  • This technique provides a more physiological environment for the heart compared to cardioplegia.