TY - JOUR
T1 - Superior septal approach versus left atrial approach for mitral valve replacement
T2 - A retrospective cohort study
AU - Ansar, Tooba
AU - Ali, Taimur Asif
AU - Shahid, Saneeha
AU - Fatimi, Saulat Hasnain
AU - Murtaza, Ghulam
N1 - Publisher Copyright:
© 2017, Pakistan Medical Association. All rights reserved.
PY - 2017/2
Y1 - 2017/2
N2 - 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.
AB - 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.
KW - Arrhythmia
KW - Left atrial approach
KW - Mitral valve replacement
KW - Mortality
KW - Superior septal approach
UR - http://www.scopus.com/inward/record.url?scp=85010858423&partnerID=8YFLogxK
M3 - Article
C2 - 28138196
AN - SCOPUS:85010858423
SN - 0030-9982
VL - 67
SP - 322
EP - 326
JO - Journal of the Pakistan Medical Association
JF - Journal of the Pakistan Medical Association
IS - 2
ER -