On-pump beating-heart mitral valve plasty without aortic cross-clamping

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Heart Valve Repair

Background:

• Ischemic cardiomyopathy frequently coexists with mitral regurgitation, necessitating surgical correction for improved long-term survival.
• Traditional mitral valve surgery involves cardiopulmonary bypass with cardiac arrest via aortic cross-clamping.
• This approach carries elevated risks, including thromboemboli and low cardiac output syndrome, particularly in patients with atherosclerotic aortas and compromised cardiac function.

Observation:

• A novel on-pump beating-heart surgical technique was employed for a patient with ischemic dilated cardiomyopathy and atrial fibrillation.
• The procedure included mitral valve plasty, coronary artery bypass grafting, tricuspid annuloplasty, left ventricular aneurysmectomy, and the maze procedure.
• Crucially, this was performed without aortic cross-clamping.

Findings:

• The patient experienced no postoperative complications following the beating-heart procedure.
• Rapid recovery was observed in the patient who underwent the complex surgical intervention.
• The absence of aortic cross-clamping mitigated the anticipated risks associated with traditional methods.

Implications:

• On-pump beating-heart mitral valve surgery without aortic cross-clamping presents a viable alternative for high-risk patients.
• This technique may significantly reduce the incidence of serious postoperative complications in ischemic cardiomyopathy.
• Further investigation into this approach could refine surgical strategies for complex cardiac conditions.