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Ann Thorac Surg 1993;55:1413-1417
© 1993 The Society of Thoracic Surgeons

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Articles

Mitral valve operation via an extended transseptal approach

Department of Cardiothoracic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina USA

^_* Address reprint requests to Dr Kon, Department of Cardiothoracic Surgery, Bowman Cray School of Medicine, Medical Center Blvd, Winston, Salem, NC 27157-1096.

The extended transseptal approach to the mitral valve has been used for 71 consecutive procedures. Four patients died; none had complications directly attributable to the exposure. Twenty underwent a primary reparative procedure; 30, a primary replacement procedure; and 21 a repeat procedure. Despite division of the sinus node artery, 26 of 32 patients with sinus rhythm preoperatively had sinus rhythm postoperatively; 4 had atrial fibrillation postoperatively. Twenty-seven of 37 patients with atrial fibrillation preoperaiively had atrial fibrillation postoperatively; 8 had sinus rhythm postoperatively. Because the exposure provided by this extended transseptal approach is superior to that of standard approaches, we now use it routinely for mitral valve operations.

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