Revista Cubana de Investigaciones Biomédicas
On-line version ISSN 1561-3011
MOJENA MORFA, Guillermo et al. Valvular mitral surgery with continuos coronary perfusion and beating heart. Rev Cubana Invest Bioméd [online]. 2008, vol.27, n.3-4, pp. 0-0. ISSN 1561-3011.
A growing interest exists to carry out myocardial revascularisations and other beating heart surgeries, without aortic clamping and whenever it is possible without the use of the extracorporeal circulation machine (ECM), since it is possible to obtain better results than those observed with the traditional techniques of myocardial protection with cardioplegic solutions. OBJECTIVE: to evaluate the safety, effectiveness and the postoperative benefits obtained in patients undergoing the technique of mitral valve replacement (MVR) with continuous coronary perfusion and beating heart compared with those operated by the technique of MVR with traditional heart stop in the Institute of Cardiology and Cardiovascular Surgery between January 2001 and December 2002. METHODS: a prospective, controlled and randomized study was designed and subjected to evaluation and approval by the committee of ethics of our Institution. i 64 patients of both sexes referred to our department for isolated MVR were selected at random and divided into two comparative groups. In the group A, MVR was performed by means of the traditional method, whereas in group B it was carried out with the heart beating. The Student's t test and Wilcoxon Mann Whitney's test were used to compare the means of the studied quantitative variables. RESULTS: In the patients of the group B, it was observed a decrease of the serum concentrations of total creatin-kinase, creatin-kinase, lactate, the total losses of blood, the need of transfusions, the time of mechanical ventilatory support, the stay in the hospital and the incidence of postoperative complications, among other variables, compared with the patients of group A. CONCLUSIONS: The evaluated surgical technique is an alternative method of myocardial protection, safe, effective and easily reproducible with which satisfactory clinical results can be attained.
Keywords : Valvular mitral surgery; beating heart.