Exposure of the mitral valve by transecting the ascending aorta during aortic and mitral valve replacement

Combined aortic and mitral valve operations are still considered major card iac surgical procedures. The duration of aortic cross-clamping and cardiopu lmonary bypass is longer, which increases morbidity and mortality for these combined, complicated operations. Aortic valve exposure is generally satis factory, but mitral valve exposure may be difficult and add to the length o f the aortic cross-clamping time [1]. We have exposed the mitral valve by t ransecting the ascending aorta, and retracting both ends apart, to give dir ect access through the dome of the left atrium in 7 patients. This approach gave good exposure and did not increase the risk of complications. Exposur e of the mitral valve through the left atrium using a superior approach, by transecting the ascending aorta, is a good option for patients with multip le cardiac conditions who are undergoing combined aortic and mitral valve o perations. (C) 2000 by The Society of Thoracic Surgeons.