Related Experiment Videos
[Transeptal access to the mitral valve. Long-term results]
G M Actis Dato1, A A Actis Dato, P Caimmi
1Divisione di Cardiochirurgia, Ospedale San Giovanni Battista, Università degli studi, Torino.
Minerva Cardioangiologica
|March 1, 1997
Summary
The transeptal approach provides excellent mitral valve exposure for repair or replacement, especially in redo operations. This technique demonstrates favorable long-term survival and low complication rates.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Valve Surgery
Background:
- Optimal mitral valve surgery necessitates superior surgical exposure.
- The transeptal approach has been utilized since 1975 at our institution.
Purpose of the Study:
- To evaluate the efficacy and safety of the transeptal approach for mitral valve surgery.
- To assess outcomes in patients undergoing mitral valve repair or replacement via a transeptal route.
Main Methods:
- A retrospective analysis of 135 patients (mean age 47.4 years) who underwent mitral valve surgery using a transeptal approach.
- Inclusion of patients with previous cardiac operations, concomitant procedures (e.g., tricuspid repair), and mechanical valve implantation (Bjork, Sorin).
Main Results:
- Excellent exposure was achieved in 95% of cases.
- Hospital mortality was 12.6%, higher in redo operations.
- Actuarial survival rates at 10 and 20 years were 83% and 70%, respectively.
- Valve-related event-free rates at 10 and 20 years were 86% and 74%.
Conclusions:
- The transeptal approach offers significant advantages for mitral valve surgery, particularly in redo cases, small left atria, and concomitant tricuspid repairs.
- The technique is associated with good exposure, favorable long-term survival, and minimal complications related to the approach.