الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 131 |  |  |
| | | from | 131 | | |
Abstract
Background: The conventional left atriotomy which is made posterior to the interatrial groove through a median sternotomy incision, is the most common approach currently used to expose the mitral valve. Despite many helpful hints to improve valve exposure through this approach, several other approaches have been described for difficult situations such as small left atrium or redo operations. Guiraudon and colleagues 1991 proposed the extended vertical transseptal approach. However the risk of transecting the sinus node artery, the internodal pathways and the need to reconstruct the wall of the atria and the interatrial septum were considered important Limitations to its routine use in mitral valve procedures.
Aim of the Work: To evaluate the safety and effectiveness of the vertical trans-septal approach as compared to standard left atriotomy for routine mitral valve surgery regarding intraoperative and early postoperative results.
Patients and Methods: Sixty four patients with mitral valve disease requiring mitral valve surgery were included. The study was done at the Cardio-thoracic surgery Department Ain Shams University and the Memorial Souad Kafafi University hospital, in the period between December 2018 and November 2019.
Results: Was conducted on 64 patients with mitral valve disease. All the patients completed the study; there was no mortality among the patients. The patients were classified into two groups: group A: The vertical trasseptal group. This group included 32 patients in whom the mitral valve was approached through the extended vertical transseptal approach. group B: The left atriotomy group. This group included 32 patients in whom the mitral valve was approached through the standard left atriotomy approach.
Conclusion: Excellent visibility of the mitral valve is important for surgical management. The extended vertical transseptal approach to the mitral valve has been shown to require minimal retraction and afford excellent visibility of the mitral valve in every case, making replacement of the valve easier.