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European Journal of Cardio-Thoracic Surgery, Vol 12, 341-344, Copyright © 1997 by European Association for Cardio-thoracic Surgery

ARTICLES

Sinus node function after mitral valve surgery via the transseptal superior approach

M Takeshita, A Furuse, Y Kotsuka and H Kubota
Department of Cardio-thoracic Surgery, Faculty of Medicine, University of Tokyo, Japan.

OBJECTIVE: The transseptal superior approach can offer an excellent view of the mitral valve but the incision almost always transects the sinus node artery. The purpose of this study was to evaluate the sinus node function after mitral operation by this approach. PATIENTS AND METHODS: We reviewed the electrocardiograms of 76 patients who underwent mitral valve operations either via transseptal superior approach or via right lateral atriotomy. Nine patients who maintained the sinus rhythm for more than one year after surgery via the transseptal superior approach were selected for electrophysiological study to evaluate the sinus node function. RESULTS AND CONCLUSIONS: Postoperative electrocardiographic and electrophysiological studies revealed that the sinus node function after the transseptal superior approach was relatively well maintained for more than one year after the operation. The influence of the transseptal superior approach on the sinus node function in the mid-term postoperative period was apparently mild and did not cause a serious problem. However, some of the patients did show abnormal data in terms of sino-atrial conduction time and intrinsic heart rate. Therefore, further follow-up of the sinus node function is necessary in patients who underwent mitral surgery through the transseptal superior approach.

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