Superior septal approach versus left atrial approach for mitral valve replacement: A retrospective cohort study

Tooba Ansar, Taimur Asif Ali, Saneeha Shahid, Saulat Hasnain Fatimi, Ghulam Murtaza

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Objective: To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement. Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]. Patients with prior history of dysrhythmia, low ejection fraction (<30%), emergency/redo mitral valve replacement and concomitant coronary artery bypass grafting were excluded. SPSS 19 was used for data analysis. Results: Of the 78 patients, 52(66.67%) were of superior septal approach and 26(33.33%) of left atrial approach. Both groups were comparable for baseline variables except cardiopulmonary bypass and cross-clamp times, which were significantly shorter in the superior septal approach group than the left septal approach group (p<0.05). No residual atrial septal defect was found in any approach. Although loss of normal sinus rhythm was observed more frequent in superior septal approach 25(48%) compared to left septal approach 10(38.4%), but the difference was statistically insignificant (p=0.28). Age was the only significant variable affecting loss of normal sinus rhythm after adjusting for approaches. The difference of post-operative complications was also statistically insignificant between superior 9(17.3%) and left septal approach 4(15.38%) (p=1.0)]. Conclusion: The operative durations were significantly higher in left atrial approach compared to superior septal approach.

Original languageEnglish
Pages (from-to)322-326
Number of pages5
JournalJournal of the Pakistan Medical Association
Issue number2
Publication statusPublished - Feb 2017
Externally publishedYes


  • Arrhythmia
  • Left atrial approach
  • Mitral valve replacement
  • Mortality
  • Superior septal approach


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