Evaluation on the Extended Transseptal Approachin Mitral Valvular Operations

Na, Myung Hoon; Park, Sang Soon; Yoon, Soo Young; Hwang, Eui Doo; Hwang, Gyung Hwan; Yu, Jae Hyun; Lim, Seung Pyung; Lee, Young

Abstract

BACKGROUND: Adequate exposure of the mitral valve is a prerequisite for mitral procedures including the repair. An extended transseptal approach in mitral valvular operations is known to have certain technical advantages in recent years because of the anatomic posterior location of the mitral valve, especially in reoperations and in the presence of the small atrium in spite of the possibility of arrhythmia due to injury of sinus nodal artery. MATERIAL AND METHOD: We compared the preoperative status, operative, and postoperative factors among patients in two study groups, transseptal only (Group I, n=10) and extended transseptal approach (Group II, n=25). RESULT: There were no differences in age, sex, NYHA functional class, left atrial size, and left ventricular function. The incidence of the redo-operation was high and early postoperative arrhythmia, which was improved later, appeared in 3 patients in Group II, but not in Group I.
CONCLUSION
We believe that atrial septal incision could be extended up to the atrial roof whenever exposure of the mitral valve during a transseptal approach is inadequate because the late results were similar.