Publication Date

1-1-2023

Journal

The Texas Heart Institute Journal

DOI

10.14503/THIJ-21-7563

PMID

36715975

Publication Date(s)

January 2023

Language

English

PMCID

PMC9969792

PubMedCentral® Posted Date

1-30-2023

PubMedCentral® Full Text Version

Post Print

Published Open-Access

no

Keywords

Humans, Cardiac Output, Low, Cardiac Surgical Procedures, Mitral Valve, Septal Occluder Device, Treatment Outcome

Abstract

Surgical approaches for mitral valve exploration vary, with the preferred approach being via the interatrial groove. Data on whether the interatrial groove approach can be used for mitral valve surgery in patients with a previously implanted Amplatzer septal occluder (ASO) (St Jude Medical, an Abbott company) are extremely limited. The authors performed mitral valve surgery using the transatrial septal approach on 2 patients following explantation of an ASO, which significantly impedes the interatrial groove approach. Concomitant surgical procedures with mitral valve replacement, removal of the ASO, and closure of an atrial septal defect with a patch significantly prolonged the cross-clamp and cardiopulmonary bypass durations, which is the reason for intraoperative low cardiac output syndrome. An intra-aortic balloon pump and venoarterial extra-corporeal membrane oxygenation were used in these 2 patients because of low cardiac output syndrome. When planning mitral valve surgery in patients with a previously implanted ASO, the device precludes the interatrial groove approach and can produce an unpredictable clinical scenario.

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