MITRAL-VALVE OPERATION VIA AN EXTENDED TRANSSEPTAL APPROACH

The extended transseptal approach to the mitral valve has been used fo r 71 consecutive procedures. Four patients died; none had complication s directly attributable to the exposure. Twenty underwent a primary re parative procedure; 30, a primary replacement procedure; and 21, a rep eat procedure. Despite division of the sinus node artery, 26 of 32 pat ients with sinus rhythm preoperatively had sinus rhythm postoperativel y; 4 had atrial fibrillation postoperatively. Twenty-seven of 37 patie nts with atrial fibrillation preoperatively had atrial fibrillation po stoperatively; 8 had sinus rhythm postoperatively. Because the exposur e provided by this extended transseptal approach is superior to that o f standard approaches, we now use it routinely for mitral valve operat ions.