The Left Atrial Roof Approach Is Better For Mitral Valve Operation In Hyphosis Patients.
KAWRYSHANKER RAJARATNAM, Esq..
FIONA STANLEY HOSPITAL, MURDOCH, Australia.
OBJECTIVE: Kyphoscolisicpatients for mitral valve procedures via Soondagard Groove,had difficult exposure,longop time,atrial tear, postop bleeding, resternotomy,tamponade,left atrial roof LAR approach prevent all complications.
METHODS: first 3 patients operated Soondagard groove had above mentioned complications.We tried via LAR in 10 patients, no such complication observed
RESULTS: Standard Soondagard grooveSG approach caused the above mentioned complications in3 young patients(1MVR,2 Repair) due to inadequate exposure resultsin inadvertant tear of atrium.LAR no such complications seen in 10 young patients(2MVR,8 Repair) due brilliant exposure.
CONCLUSIONS: LAR approach offer brilliant exposure to the mitral valve in all patients. SG compromise the exposure of the mitral valve due to the spinal abnormality secondarily affect the cardiac anatomy. Specially most posterior aspect of the heart Let atrium.LA1.Despite the enlarged LA. Due to the concavity of the spine the pulmonary vein are crowded because LA is cephalocaudally shortened i.e. SG shortened.2.LA enlarged side to side therefore mitral valve is pushed away from the SG. Both anatomical alteration difficult MVexposure.3.Thoracic anteroposterior dimension is increased in kyphoscoliosis
LARapproach eliminates anatomical difficulties and giving brilliant exposure,prevent LA tear and all the potential complications.
Back to 2017 Display Posters