Intraoperative Assessment for Mitral Valve Competency in a Beatin Heart Under Retrograde Coronary Perfusion
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- Miyairi Takeshi
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Miura Sumio
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Taketani Tsuyoshi
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Kusuhara Takayoshi
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Lee Yangsin
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Unai Shinya
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Ohno Takayuki
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Fukuda Sachito
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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- Takamoto Shinichi
- Department of Cardiovascular Surgery, Mitsui Memorial Hospital
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抄録
Intraoperative assessment of a repaired mitral valve is of paramount importance for reparative mitral surgery. From September 2010 through November 2012, 20 consecutive patients underwent mitral valve plasty for mitral regurgitation. The patients who underwent surgery after June 2012 received assessment of the repair with the heart beating (HB group, n = 10), and the patients who underwent the operation before May 2012 were assessed for the repair only under cardioplegic heart arrest (non-HB group, n = 10). Intermittent cold retrograde blood cardioplegia was used in all patients. In the HB-group, after completion of the procedures, pump blood without a crystalloid additive was delivered into the coronary sinus. The function of the mitral valve was assessed under beating conditions. There were no differences between the two groups in aortic cross clamp time and operation time, although operative and concomitant procedures were slightly more complicated in the HB group than in the non-HB group. Postoperative echocardiography revealed none or mild mitral regurgitation in all the patients in both groups. Reopening of the closed left atrium for additional repair was necessary only in one patient in the HB group and 3 patients in the non-HB group. In conclusion, the method of perfusing the myocardium retrogradely via the coronary sinus with warm blood is safe and effective for assessing the competency of the mitral valve in a beating heart.
収録刊行物
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- International Heart Journal
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International Heart Journal 54 (4), 192-195, 2013
一般社団法人 インターナショナル・ハート・ジャーナル刊行会