Title: Post CMV Mitral Valve Replacement: A Different Approach
Authors: Dr Tinni Mitra, Dr Chandan Saha
DOI: https://dx.doi.org/10.18535/jmscr/v8i2.93
Abstract
Aim: To study the pros and cons of surgery without releasing adhesions in post CMV (Closed Mitral Vulvotomy) patients
Materials and Methods: A total of 42 patients underwent Mitral valve replacement between October 2017- January 2019. Of these 20 patients underwent MVR using the novel approach and 22 patients went for conventional MVR. The difference in operative approach involved incomplete pericardiotomy.
Result: Time to initiate cardiopulmonary bypass was significantly longer in case of conventional procedure as compared to the modification. However Cardiopulmonary bypass time and cross clamp times, which point to the technical ease of operation, were similar in both cases .Fall in hematocrit was slightly more in the conventional group which signifies increased incidence of blood loss in conventional procedure. The noted complications were slightly different between the two groups, conventional group showed a high incidence of chamber injury and injury to coronary arteries
Conclusion: This study demonstrates that surgery for mitral valves in post CMV patients can be done equally effectively without releasing the dense adhesions between pericardium and cardiac chamber which is a tedious, difficult and time consuming procedures. Since the total time required for operation was less in the alternative method, this would mean shorter period of General Anesthesia which is beneficial for the patient, the surgeon and the anesthetist concerned.
Mesh Terms: Redo MVR, CMV, Cardiopulmonary bypass.
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