Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?

Detalhes bibliográficos
Autor(a) principal: Guedes,Marco Antonio Vieira
Data de Publicação: 2010
Outros Autores: Pomerantzeff,Pablo Maria Alberto, Brandão,Carlos Manuel de Almeida, Vieira,Marcelo Luiz Campos, Grinberg,Max, Stolf,Noedir Antonio Groppo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382010000300007
Resumo: INTRODUCTION: The right anterolateral thoracotomy is an alternative technique for surgical approach of mitral valve. In these cases, femoral-femoral bypass still has been used, rising occurrence of complications related to femoral cannulation. Objective: Describe the technique and results of mitral valve treatment by right anterolateral thoracotomy using aortic cannulation for cardiac pulmonary bypass (CPB). METHODS: From 1983 e 2008, 100 consecutive female patients, with average age 35 ±13 years, 96 (96%) underwent mitral valve surgical treatment in the Heart Institute of São Paulo. A right anterolateral thoracotomy approach associated with aortic cannulation was used for CPB. Eighty (80%) patients had rheumatic disease and 84 (84%) patients presented functional class III or IV. RESULTS: Were performed 45 (45%) comissurotomies, 38 (38%) valve repairs, 7(7%) mitral valve replacements, seven (7%) recomissurotomies and three (3%) prosthesis replacement. Sparing surgery was performed in 90 (90%) patients. The average CPB and clamp time were 57 ± 27 min e 39 ± 19 min, respectively. There were no in-hospital death, reoperation due to bleeding and convertion to sternotomy. Introperative complications were related to heart harvest (5%), especially in reoperations (3%). The most important complications in postoperative period were related to pulmonary system (11%), followed by atrial fibrilation (10%) but without major systemic repercussions. The mean inhospital length of stay was 8 ± 3 days. Follow-up was 6.038 patients/month. Actuarial survival was 98.0 ± 1.9% and freedom from reoperation was 81.4 ± 7.8% in 180 months. CONCLUSION: The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety.
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spelling Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?Mitral valveExtracorporeal circulationThoracic surgeryHeart valvesSurgical procedures, minimally invasiveINTRODUCTION: The right anterolateral thoracotomy is an alternative technique for surgical approach of mitral valve. In these cases, femoral-femoral bypass still has been used, rising occurrence of complications related to femoral cannulation. Objective: Describe the technique and results of mitral valve treatment by right anterolateral thoracotomy using aortic cannulation for cardiac pulmonary bypass (CPB). METHODS: From 1983 e 2008, 100 consecutive female patients, with average age 35 ±13 years, 96 (96%) underwent mitral valve surgical treatment in the Heart Institute of São Paulo. A right anterolateral thoracotomy approach associated with aortic cannulation was used for CPB. Eighty (80%) patients had rheumatic disease and 84 (84%) patients presented functional class III or IV. RESULTS: Were performed 45 (45%) comissurotomies, 38 (38%) valve repairs, 7(7%) mitral valve replacements, seven (7%) recomissurotomies and three (3%) prosthesis replacement. Sparing surgery was performed in 90 (90%) patients. The average CPB and clamp time were 57 ± 27 min e 39 ± 19 min, respectively. There were no in-hospital death, reoperation due to bleeding and convertion to sternotomy. Introperative complications were related to heart harvest (5%), especially in reoperations (3%). The most important complications in postoperative period were related to pulmonary system (11%), followed by atrial fibrilation (10%) but without major systemic repercussions. The mean inhospital length of stay was 8 ± 3 days. Follow-up was 6.038 patients/month. Actuarial survival was 98.0 ± 1.9% and freedom from reoperation was 81.4 ± 7.8% in 180 months. CONCLUSION: The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety.Sociedade Brasileira de Cirurgia Cardiovascular2010-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382010000300007Brazilian Journal of Cardiovascular Surgery v.25 n.3 2010reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.1590/S0102-76382010000300007info:eu-repo/semantics/openAccessGuedes,Marco Antonio VieiraPomerantzeff,Pablo Maria AlbertoBrandão,Carlos Manuel de AlmeidaVieira,Marcelo Luiz CamposGrinberg,MaxStolf,Noedir Antonio Groppoeng2010-11-11T00:00:00Zoai:scielo:S0102-76382010000300007Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2010-11-11T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false
dc.title.none.fl_str_mv Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
title Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
spellingShingle Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
Guedes,Marco Antonio Vieira
Mitral valve
Extracorporeal circulation
Thoracic surgery
Heart valves
Surgical procedures, minimally invasive
title_short Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
title_full Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
title_fullStr Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
title_full_unstemmed Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
title_sort Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?
author Guedes,Marco Antonio Vieira
author_facet Guedes,Marco Antonio Vieira
Pomerantzeff,Pablo Maria Alberto
Brandão,Carlos Manuel de Almeida
Vieira,Marcelo Luiz Campos
Grinberg,Max
Stolf,Noedir Antonio Groppo
author_role author
author2 Pomerantzeff,Pablo Maria Alberto
Brandão,Carlos Manuel de Almeida
Vieira,Marcelo Luiz Campos
Grinberg,Max
Stolf,Noedir Antonio Groppo
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Guedes,Marco Antonio Vieira
Pomerantzeff,Pablo Maria Alberto
Brandão,Carlos Manuel de Almeida
Vieira,Marcelo Luiz Campos
Grinberg,Max
Stolf,Noedir Antonio Groppo
dc.subject.por.fl_str_mv Mitral valve
Extracorporeal circulation
Thoracic surgery
Heart valves
Surgical procedures, minimally invasive
topic Mitral valve
Extracorporeal circulation
Thoracic surgery
Heart valves
Surgical procedures, minimally invasive
description INTRODUCTION: The right anterolateral thoracotomy is an alternative technique for surgical approach of mitral valve. In these cases, femoral-femoral bypass still has been used, rising occurrence of complications related to femoral cannulation. Objective: Describe the technique and results of mitral valve treatment by right anterolateral thoracotomy using aortic cannulation for cardiac pulmonary bypass (CPB). METHODS: From 1983 e 2008, 100 consecutive female patients, with average age 35 ±13 years, 96 (96%) underwent mitral valve surgical treatment in the Heart Institute of São Paulo. A right anterolateral thoracotomy approach associated with aortic cannulation was used for CPB. Eighty (80%) patients had rheumatic disease and 84 (84%) patients presented functional class III or IV. RESULTS: Were performed 45 (45%) comissurotomies, 38 (38%) valve repairs, 7(7%) mitral valve replacements, seven (7%) recomissurotomies and three (3%) prosthesis replacement. Sparing surgery was performed in 90 (90%) patients. The average CPB and clamp time were 57 ± 27 min e 39 ± 19 min, respectively. There were no in-hospital death, reoperation due to bleeding and convertion to sternotomy. Introperative complications were related to heart harvest (5%), especially in reoperations (3%). The most important complications in postoperative period were related to pulmonary system (11%), followed by atrial fibrilation (10%) but without major systemic repercussions. The mean inhospital length of stay was 8 ± 3 days. Follow-up was 6.038 patients/month. Actuarial survival was 98.0 ± 1.9% and freedom from reoperation was 81.4 ± 7.8% in 180 months. CONCLUSION: The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety.
publishDate 2010
dc.date.none.fl_str_mv 2010-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382010000300007
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0102-76382010000300007
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
dc.source.none.fl_str_mv Brazilian Journal of Cardiovascular Surgery v.25 n.3 2010
reponame:Brazilian Journal of Cardiovascular Surgery (Online)
instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
instname_str Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron_str SBCCV
institution SBCCV
reponame_str Brazilian Journal of Cardiovascular Surgery (Online)
collection Brazilian Journal of Cardiovascular Surgery (Online)
repository.name.fl_str_mv Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
repository.mail.fl_str_mv ||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br
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