The Superior Approach to the Mitral Valve: A Review of Clinical Experience

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Abstract

Our experience with the superior approach to the mitral valve includes 305 patients. The superior aspect of the left atrium as it presents in the transverse sinus between the aorta and superior vena cava is incised transversely to gain access to the valve. Care must be taken to avoid injuring the area adjacent to the aortic root. This approach consistently affords good exposure to the commissures and subvalvular structures of the mitral valve. Careful hemostasis is necessary in closing the atrium, as control of bleeding is difficult after bypass is discontinued.

Using this exposure, we have operated upon 210 female and 95 male patients. The approach is especially effective when the aortic valve must be corrected in addition to the mitral valve. There were 50 patients in whom multiple valves were corrected. The overall mortality in this series is 9%. We believe that the method compares very favorably with other methods now in use.

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Presented at the Seventh Annual Meeting of The Society of Thoracic Surgeons, Dallas, Tex., Jan. 18-20, 1971.

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