Mitral valve repair using continuous warm blood cardioplegia

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Cardiac Anesthesia

Background:

• Congenital heart disease frequently involves mitral valve insufficiency.
• Achieving satisfactory mitral valve repair is crucial for pediatric cardiac surgery outcomes.
• Current techniques for mitral valve repair require continuous assessment and refinement.

Purpose of the Study:

• To evaluate the efficacy and safety of continuous warm blood cardioplegia for mitral valve repair in pediatric patients.
• To assess the functional competence of the mitral valve during and after repair procedures.
• To determine the feasibility of alternating perfusion techniques during cardiac arrest.

Main Methods:

• Application of continuous warm blood cardioplegia in seven children undergoing mitral valve repair for congenital heart disease.
• Assessment of mitral valve competency using a test solution injection with a beating heart under warm blood perfusion.
• Performance of mitral valve repair under normothermic cardiac arrest with continuous antegrade warm blood cardioplegia perfusion.
• Alternation of procedures by adjusting cardioplegia potassium concentration.

Main Results:

• No operative deaths or procedure-related complications were observed in the seven patients.
• Postoperative echocardiography revealed good mitral valve function with none to trivial regurgitation in six patients (86%).
• Satisfactory initial repair was achieved in 4 cases, with repeat procedures in 3 patients.

Conclusions:

• Continuous warm blood cardioplegia is a safe and useful tool for mitral valve repair in children.
• The technique allows for safe alternation between perfusion and arrest states.
• The method promotes good postoperative mitral valve function and reduces regurgitation.