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Eur J Cardiothorac Surg 2005;28:198-199
© 2005 Elsevier Science NL

Original articles

Editorial comment

Off-pump mitral valve replacement: an attack on conventional heart surgery?

Department of Cardiovascular Surgery, University of Kiel, School of Medicine, 24105 Kiel, Germany

^* Corresponding author. Tel.: +49 431 597 4401; fax: +49 431 597 4402 (Email: lutter@kielheart.uni-kiel.de).

The first 20% of the full text of this article appears below.

The pioneering introduction of the Starr–Edwards valve allowed complete replacement of the diseased mitral valve. With improved cardiopulmonary bypass, myocardial protection, and surgical techniques the mortality rate associated with mitral valve replacement decreased. Augmented use of mitral valve repair techniques has resulted in a substantial decrease in long-term morbidity and mortality when treating patients with mitral regurgitation. Some believed that this resulted from maintaining continuity of the mitral annular papillary muscle continuity during mitral valve repair. Additional studies have validated the positive long-term effects of maintaining the integrity of the mitral valve subvalvular apparatus [1]. Although surgical approaches to reduce mitral regurgitation associated with congestive heart failure have been reported, the high mortality rate that accompanies surgery in patients with severe heart failure and the short-term hemodynamic effect of alleviating mitral regurgitation in the setting of a failing ventricle are still of significant concern [2,3].

The maintenance of integrity of the subvalvular apparatus has also been performed in a new off-pump mitral valve study providing a very attractive treatment option: in this month's edition . . . [Full Text of this Article]