Beating heart mitral valve replacement with retrograde coronary sinus perfusion technique

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Mitral valve replacement is a critical procedure for managing severe mitral valve disease.
• Traditional cardiopulmonary bypass can lead to myocardial stunning and systemic inflammatory response.
• Beating heart techniques aim to minimize myocardial ischemia and preserve cardiac function.

Purpose of the Study:

• To evaluate the efficacy and applicability of on-pump beating heart mitral valve replacement.
• To assess the use of Sorin Bicarbon prosthesis with retrograde coronary sinus perfusion.
• To analyze operative variables and early outcomes of this specific surgical approach.

Main Methods:

• Prospective study of 17 consecutive patients undergoing mitral valve replacement.
• Utilized on-pump beating heart technique with Sorin Bicarbon prosthesis.
• Employed retrograde coronary sinus perfusion for myocardial protection and venting via aorta and pulmonary vein for visualization.

Main Results:

• Retrograde coronary sinus perfusion and effective venting facilitated excellent surgical field visualization and procedural ease.
• Postoperative cardiac enzyme levels (creatine kinase-MB and troponin T) were within acceptable ranges.
• No mortality or major complications were observed; all patients were discharged in good condition.

Conclusions:

• On-pump beating heart mitral valve replacement with the Sorin Bicarbon prosthesis is a viable and safe surgical option.
• This technique offers the advantage of maintaining the heart's physiologic condition throughout the procedure.
• The use of retrograde coronary sinus perfusion supports the feasibility and positive outcomes of this approach.