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Ann Thorac Surg 2000;69:646-647
© 2000 The Society of Thoracic Surgeons

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Exposure of the mitral valve by transecting the ascending aorta during aortic and mitral valve replacement

^a Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Address reprint requests to Dr Machiraju, Division of Thoracic Surgery, Shadyside Hospital, 5200 Center Ave, Pittsburgh, PA 15232
e-mail: rajca{at}ssh.edu

Combined aortic and mitral valve operations are still considered major cardiac surgical procedures. The duration of aortic cross-clamping and cardiopulmonary bypass is longer, which increases morbidity and mortality for these combined, complicated operations. Aortic valve exposure is generally satisfactory, but mitral valve exposure may be difficult and add to the length of the aortic cross-clamping time [1]. We have exposed the mitral valve by transecting the ascending aorta, and retracting both ends apart, to give direct access through the dome of the left atrium in 7 patients. This approach gave good exposure and did not increase the risk of complications. Exposure of the mitral valve through the left atrium using a superior approach, by transecting the ascending aorta, is a good option for patients with multiple cardiac conditions who are undergoing combined aortic and mitral valve operations.

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