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Sinus Node Function after Extended Transseptal Approach for Mitral Valve Surgery: 164 Clinical Cases  

Ryu Se Min (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Kim Hyun Koo (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Cho Yang Hyun (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Sim Jae Hoon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Sohn Young-sang (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Choi Young Ho (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Kim Hark Jei (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
Publication Information
Journal of Chest Surgery / v.38, no.3, 2005 , pp. 214-220 More about this Journal
Abstract
Extended transseptal approach can provide an excellent view of the mitral valve but the safety of this approach is controversial because this incision requires transaction of the sinus node artery, which in most cases and can result postoperative arrhythmia. The purpose of this study was to evaluate perioperative and longterm conduction disturbances and the cardiac rhythms of patients who underwent an extended transseptal approach for mitral valve surgery. Material and Method: Postoperative cardiac rhythms were analyzed in the 164 consecutive patients who received mitral valve replacements with a extended transseptal approach between March 1992 and July 2003. Result: Of the 84 patients in normal sinus rhythm, 34 ($39\%$) had developed transient junctional rhythm and atrial fibrillation after operation, lasting less than 72 hours in most of cases. No intractable arrhythmias occurred. Most of these arrhythmia were not detected at the time of discharge and only 8 patients ($9\%$) had atrial fibrillation at discharge. Postoperative PR intervals increased for 1 week, then decreased within 2 weeks postoperatively, and returned to normal range by 6 months postoperatively. During the postoperative period, 4 of the 78 patients with preoperative atrial fibrillation developed normal sinus thythm. Conclusion: The post-operative arrhythmias were temporary and showed no significant complications after extended transseptal approach for the mitral valve surgery.
Keywords
Surgery method; Mitral valve; surgery; Arrhythmia;
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