Mitral valve operation via an extended transseptal approach

Kon, Neal D.; Tucker, William Y.; Mills, Stephen A.; Lavender, Sidney W.; Cordell, A. Robert

doi:10.1016/0003-4975(93)91081-w

Cited by 44 publications

(15 citation statements)

References 16 publications

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“…[1][2][3][4][5]9,10 Our results showed that although the operative field was smaller than that of the classic approach, the modified approach was always closer to the edge of the mitral valve, so its exposure was relatively simple in all cases. Furthermore, closure after this approach was much simpler than after the classic approach.…”

Section: Discussionmentioning

confidence: 76%

Improved Combined Superior-Transseptal Approach to the Mitral Valve

Nguyen

2009

Asian Cardiovasc Thorac Ann

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In mitral valve surgery, the combined superior-transseptal approach gives excellent exposure of the mitral valve, but it is lengthy and complex. A modified version of this approach was made without cutting the right atrial appendage and the dome of the right atrium. This shorter procedure was evaluated in 30 patients aged 4-61 years undergoing complex mitral valve operations including mitral repair (33.3%), reoperation (30%), and small left atrium (30%). The mitral valve was exposed well in all cases. Because of the shorter incision, closure was relatively easy. The aortic crossclamp time was 117 +/- 29.9 min (range, 53-173). There were no major complications. Cardiac rhythm resumed spontaneously after release of the aortic clamp in 93.3% of patients, including 36.7% who regained sinus rhythm from arrhythmia preoperatively. There was no heart block, bleeding, or mortality. Results at 3 months were good. Despite a decreased operative field, this modified approach provided adequate exposure for all the required techniques. The benefits of this approach are a shorter incision in the atrial muscle, and simplified closure technique.

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Section: Discussionmentioning

confidence: 76%

Improved Combined Superior-Transseptal Approach to the Mitral Valve

Nguyen

2009

Asian Cardiovasc Thorac Ann

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“…We used this approach as it provides an excellent exposure especially when the left atrium is not dilated, as is the case in most of the patient of ischemic mitral insufficiency. Superior septal approach provides very good visibility and accessibility and this approach is especially useful in small left atrium and repeat surgery 8,9 . Inspite of reports 10,11 of conduction disturbances associated with the superior septal approach, we did not notice any increased incidence of such dysrrhythmias.…”

Section: Resultsmentioning

confidence: 99%

Combining off pump coronary artery bypass with mitral valve replacement

Bana

Sharma

Das

et al. 2007

Indian J Thorac Cardiovasc Surg

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“…Both incisions are then joined at the superior end of the interatrial septum and are extended into the left atrial roof transversely. Basically the same technique has been described by other authors [8,9], who named the procedure 'septal-superior (or transplant) approach' and 'extended transseptal approach', respectively.…”

Section: Discussionmentioning

confidence: 99%

Extended vertical transatrial septal approach for the removal of left atrial myxoma

Zeebregts

Schepens

Knaepen

1998

European Journal of Cardio-Thoracic Surgery

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Objective: Optimal exposure greatly facilitates left atrial myxomectomy and is mandatory for safe and efficacious tumour removal. The purpose of this study was to evaluate one institutions experience, with an alternative to the classical approach, for the removal of left atrial myxoma. Methods: In an eight-year period, eight patients underwent surgical removal of left atrial myxoma at our institution using the extended vertical transatrial septal approach, slightly modified compared to the original method of Guiraudon and associates, as the septum was initially incised superiorly instead of through the fossa ovalis. Results: One patient with poor left ventricular function died shortly after the surgical procedure because of low cardiac output. Postoperative course of the other patients was uneventful. No rethoracotomy for bleeding was carried out and no permanent arrhythmias were seen. There was one late death at 4.5 months after operation, for which no clear reason was found. Mean follow-up was 55 months (range 1 to 79 months) and revealed six asymptomatic healthy patients. Conclusions: We feel that the extended vertical transatrial septal approach provides good exposure of left atrial tumours and facilitates complete surgical removal without inherent complications such as tumour cell dissemination or fragmentation.

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Mitral valve operation via an extended transseptal approach

Cited by 44 publications

References 16 publications

Improved Combined Superior-Transseptal Approach to the Mitral Valve

Improved Combined Superior-Transseptal Approach to the Mitral Valve

Combining off pump coronary artery bypass with mitral valve replacement

Extended vertical transatrial septal approach for the removal of left atrial myxoma

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