HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Joe R. Utley Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Utley, J. R. Articles by Nguyenduy, T. Search for Related Content PubMed PubMed Citation Articles by Utley, J. R. Articles by Nguyenduy, T.

J Thorac Cardiovasc Surg 1995;109:582-587
© 1995 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

Comparison of outcomes with three atrial incisions for mitral valve operationsRight lateral, superior septal, and transseptal

Spartanburg, S.C.

Supported by the Cardiothoracic Research and Education Foundation.

Received for publication June 2, 1994. Accepted for publication Sept. 30, 1994. Address for reprints: Joe R. Utley, MD, 100 E. Wood St., Suite 300, Spartanburg, SC 29303.

Abstract

We compared the preoperative status, operative factors, and postoperative outcomes among patients having mitral valve operations with three atrial incisions. The incisions were right lateral (n = 66), superior septal (n=46), and transseptal (n=37). Differences in patient and operative factors among the groups were not predictors of adverse postoperative outcomes with multiple regression analysis. Postoperative pulmonary failure was less common in the superior septal group. Patients in the superior septal group more commonly required permanent pacemakers than those in the right lateral group. In patients with sinus rhythm before operation, sinus rhythm had returned before hospital discharge more commonly in those in the right lateral group (35 of 44, 80%) than in those in the superior septal group (18 of 28, 46%) or in the transseptal group (9 of 13, 69%). With multiple regression analysis the type of atrial incision was not a predictor of postoperative pulmonary failure or need for permanent pacemaker. Right lateral and transseptal atrial incisions were predictors of retention of sinus rhythm after operation. We conclude that the results of superior septal incision are comparable with those of other incisions except for a slightly greater risk of loss of sinus rhythm. One must weigh the technical advantages of the superior septal incision against the risk of loss of sinus rhythm. (J THORAC CARDIOVASC SURG 1995; 109: 582-7)

This article has been cited by other articles:

				H. U. Nguyen Improved Combined Superior-Transseptal Approach to the Mitral Valve Asian Cardiovasc Thorac Ann, April 1, 2009; 17(2): 171 - 174. [Abstract] [Full Text] [PDF]

				S. Little, M. Flynn, G. B. Pettersson, A. M. Gillinov, and E. H. Blackstone Revisiting the dome approach for partial sternotomy/minimally invasive mitral valve surgery. Ann. Thorac. Surg., March 1, 2009; 87(3): 694 - 697. [Abstract] [Full Text] [PDF]

				T. Gudbjartsson, T. Absi, and S. Aranki Mitral Valve Replacement Card. Surg. Adult, January 1, 2008; 3(2008): 1031 - 1068. [Full Text]

				P. Lukac, V. E. Hjortdal, A. K. Pedersen, P. T. Mortensen, H. K. Jensen, and P. S. Hansen Superior Transseptal Approach to Mitral Valve Is Associated With a Higher Need for Pacemaker Implantation Than the Left Atrial Approach Ann. Thorac. Surg., January 1, 2007; 83(1): 77 - 82. [Abstract] [Full Text] [PDF]

				J. J. Nienaber and D. D. Glower Minitransseptal versus left atrial approach to the mitral valve: a comparison of outcomes. Ann. Thorac. Surg., September 1, 2006; 82(3): 834 - 839. [Abstract] [Full Text] [PDF]

				P. Lukac, V. E. Hjortdal, A. K. Pedersen, P. T. Mortensen, H. K. Jensen, and P. S. Hansen Atrial Incision Affects the Incidence of Atrial Tachycardia After Mitral Valve Surgery Ann. Thorac. Surg., February 1, 2006; 81(2): 509 - 513. [Abstract] [Full Text] [PDF]

				D. Wheatley and M. Will Mitral valve replacement with mechanical or bioprosthetic valve MMCTS, April 25, 2005; 2005(0425): 1024. [Abstract] [Full Text] [PDF]

				T. Gudbjartsson, S. Aranki, and L. H. Cohn Mechanical/Bioprosthetic Mitral Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 951 - 986. [Full Text]

				H. Shin, R. Yozu, S. Higashi, and S. Kawada Sinus node function after mitral valve surgery using the superior septal approach Ann. Thorac. Surg., February 1, 2001; 71(2): 587 - 590. [Abstract] [Full Text] [PDF]

				Y. Misawa, K. Fuse, K. Kawahito, T. Saito, and H. Konishi Conduction disturbances after superior septal approach for mitral valve repair Ann. Thorac. Surg., October 1, 1999; 68(4): 1262 - 1264. [Abstract] [Full Text] [PDF]

				M. Pasic, M. Musci, H. Siniawski, B. Edelmann, T. Tedoriya, and R. Hetzer Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation J. Am. Coll. Cardiol., October 1, 1998; 32(4): 1040 - 1047. [Abstract] [Full Text] [PDF]

				M. Masuda, R. Tominaga, Y. Kawachi, F. Fukumura, S. Morita, Y. Imoto, Y. Toshima, Y. Tomita, and H. Yasui Postoperative Cardiac Rhythms With Superior-Septal Approach and Lateral Approach to the Mitral Valve Ann. Thorac. Surg., October 1, 1996; 62(4): 1118 - 1122. [Abstract] [Full Text]