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Updated: Jun 17, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

Beating-heart valve surgery: A systematic review.

Kareem Salhiyyah¹, David Taggart

¹Department of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Trust, London, UK. kareemsal@doctors.org.uk

Asian Cardiovascular & Thoracic Annals

|December 23, 2009

Summary

Beating-heart continuous coronary perfusion (BHCCP) in valve surgery shows no advantage over cardioplegic arrest, despite potential benefits in reducing myocardial injury. High-quality trials are needed to confirm its role.

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Area of Science:

Cardiovascular Surgery
Cardiac Surgery Techniques

Background:

Beating-heart continuous coronary perfusion (BHCCP) is proposed as an alternative to cardioplegic arrest in valve surgery.
Potential benefits include avoiding cardioplegia and ischemic reperfusion injury, particularly in complex procedures like mitral valve repair.

Purpose of the Study:

To systematically review the evidence comparing the efficacy of BHCCP versus cardioplegic arrest in valve surgery.

Main Methods:

A systematic review of 39 reports was conducted.
Analysis included assessment of study quality and evidence levels; only two reports were randomized controlled trials.

Main Results:

Studies were generally of poor quality with low evidence levels.
BHCCP demonstrated acceptable mortality and morbidity but no superiority over cardioplegic arrest.
Weak evidence suggests BHCCP may reduce myocardial injury markers.

Conclusions:

BHCCP is a potential operative strategy in valve surgery with possible benefits for myocardial injury.
A high-quality, prospective randomized controlled trial is necessary to define the precise role of BHCCP in complex valve surgery.