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The Alternative Way To Reach To The Mitral Valve In Patients With Small Left Atrium; Superior Septal Approach
Serkan Ketenciler1, Muslum Polat1, Murat Ercisli2, Mehmet Kucukosmanoglu3, Gokalp Guzel1, Metin Kaplan4, Birol Yamak2.
1Gaziantep Dr. Ersin Arslan State Hospital Cardiovascular Surgery Clinic, Gaziantep, Turkey, 2Adiyaman University Medical Faculty Cardiovascular Surgery Department, Adiyaman, Turkey, 3Gaziantep Dr. Ersin Arslan State Hospital Cardiology Clinic, Gaziantep, Turkey, 4Gaziantep Dr. Ersin Arslan State Hospital Anesthesiology Clinic, Gaziantep, Turkey.

It is an important problem to reach the mitral valve for the patients that will be operated for the mitral valve pathology with small left atrium. In this study, we wanted to show superior septal approach is safe and alternative way to reach mitral valve for the cases that it is difficult to reach mitral valve by the standart way. Totally 227 patients that performed mitral valve replacement and/or with additional procedures were added to study between 2001 and 2013. Isolated mitral valve replacement or concomitantly coronary artery bypass grafting, aortic valve replacement or tricuspid valve repair operation were performed to patients. The patients evaluated for transient or permanent rhythm disorders and early mortality. Transient rhythm disorders were seen 10 % of patients but permanent rhythm disorder was detected only one patient. Hospital mortality was 3.6 %. To reach the mitral valve by the way of superior septal approach extends cross clemp time. When administered with caution it is not cause permanent rhythm disorders. We consider that superior septal approach for the patients that needed surgical mitral valve intervention with small left atrium is safe and alternative way.

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