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Abstract
With chronic mitral regurgitation, after the initial compensatory phase, LV systolic contractility becomes progressively impaired. So, properly timed surgical correction of chronic mitral regurgitation is necessary to preserve LV contractility. (Yun et al., 1992) When LV systolic function is affected, the attention will be directed to the myocardial protection hoping in attenuating or preventing myocardial dysfunction that occurs during and after surgery. (Mentzer et al., 2003) Still, in spite of improvements in myocardial protection techniques, some perioperative adverse effects of myocardial ischemia caused by aortic cross-clamping, cardioplegia, and reperfusion remain (Weman et al., 2000). Therefore, great effort is made to prevent these deleterious effects (Mauny et al., 1995) Any technique that avoids the ischemic component of cardioplegia and an arrested heart by keeping the heart beating will go a long way in reducing iatrogenic damage to the heart. (Bedi et al., 2003<Introduction of off-pump beating heart operations has enabled major technological and procedural advances in coronary artery bypass grafting. (Calafiore et al., 1996) We have considered the possibility of conducting valvular operations on the beating heart similarly. Although this procedure cannot be performed without using CPB, it eliminates the ischemic component by keeping the heart beating throughout the operation. (Bedi et al., 2003)