Superior Septal Approach to Mitral Valve Surgery [1]
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This video demonstrates the case of a 47-year-old male patient who was diagnosed with severe mitral valve regurgitation and prolapse in P2. The patient was in NYHA functional class II, and a mitral valve repair was performed by P2 quadrangular resection, plus annuloplasty. A superior septal approach was used to address the mitral valve.
Critical Surgical Steps:
- Use bicaval cannulation.
- Insert a right-angled cannula in the superior vena cava.
- Cross-clamp the aorta and administer the cardioplegia.
- Open the right atrium parallel to the right atrio-ventricular groove.
- Open the interatrial septum on the fossa ovalis.
- Join both incisions at the mid-point between the ascending aorta and superior vena cava.
- Extend the incision upwards in the left atrial roof before reaching the base of the left atrial appendage.
- Expose the mitral valve with one or two small retractors.
- Perform the mitral valve repair.
- Close the incision in the left atrial roof with double-running 3/0 Prolene suture.
- Close the incision in the fossa ovalis with double-running 3/0 Prolene suture, until reaching the other suture.
- Close the upper end of the incision in the right atrium with double-running 3/0 Prolene suture.
- Close the lower end of the right atriotomy with double-running 4/0 Prolene suture until the two ends of the suture line are joined.
- Complete the operation as usual.
Subspecialty(ies):
Cardiac [3]
Content Area(s):
Residents [4]
Videos - General [5]