Comparative study on the short term outcome of left atrial versus superior transeptal approach in mitral valve surgery

Abstract

The conventional left atriotomy which is made posterior to the interatrial groove through a median sternotomy incision, is the most common approach currently used to expose the mitral valve. Despite many helpful hints to improve valve exposure through this approach, several other approaches have been described for difficult situations such as small left atrium or redo operations. Guiraudon and colleagues 1991 proposed the extended vertical transseptal approach. However the risk of transecting the sinus node artery, the internodal pathways and the need to reconstruct the wall of the atria and the interatrial septum were considered important Limitations to its routine use in mitral valve procedures.

In this study, 64 patients with mitral valve disease requiring mitral valve surgery were divided into two groups.

Group A: 32 patients had mitral valve surgery through extended vertical transseptal approach

Group B: 32 patients had mitral valve surgery through conventional left atrial approach

There was no significant statistical difference between the two groups as regards, the age, sex, preoperative echocardiographic findings as left atrial dimension, or mitral valve pathology and preoperative patients' cardiac rhythm.

Regarding intraoperative course, there was no significant statistical difference in the aortic cross-clamp time, total cardiopulmonary bypass time, and the use of