Abstract 3238: Successful Direct Endoscopic Guided Double Valve Repair on the Beating Heart: Acute Calves Study
Objectives: The purpose of this study was to develop a new method for mitral and tricuspid valve surgery under direct endoscopic visualization on the beating heart.
Method: Through a median sternotomy, the cardiopulmonary bypass (CPB) was established in 6 calves. The clear solution was administrated to the pulmonary artery (PA) first to flush out any blood in the lungs, which was drained through the left ventricular (LV) cannula. The fiberoptic endoscope with open-end translucent outer sheath was inserted through the LV epicardially. During the manipulation, the clear solution was administrated to the left side of the heart. The endoscopic clip was used for an edge-to-edge repair of the both mitral and tricuspid valves. After the mitral valve clipping, the coronary sinus was occluded epicardially, and the fiberscope was inserted into the right ventricle. The clear solution was administered from the right atrium and drained from the PA continuously. After tricuspid valve repair, the animal was weaned form the CPB.
Results: The mitral valve repair was successful in all 6 cases, and the successful double valve repair was carried out in the last five cases. All cases were weaned from the CPB with dobutamine (3.3±1.9 μg/min/kg) only. The hematocrit was maintained during the procedure (Pre: 29.9% vs. Post 31.1%).
Conclusions: This study showed the technical feasibility of beating-heart mitral and tricuspid valve surgery with the direct endoscopic image. The damage derived from the insertion of equipments was demonstrated to be harmless for the cardiac function. Our sequential successful experiment will show the way to the minimally invasive method in the future.