Cardiovascular Surgery Mitral valve Repair

Mitral Valve Repair

Objective

•   To open chest 

•   To repair the mitral valve in mitral regurgitation. 

Position

•   Supine or left lateral 

Anesthesia

General.

Procedure

   1.  Catheterization. 

   2.  Cleaning and draping. 

   3.  Skin incision.

   4.  Saw and cable for mid-sternotomy incision.

   5.  Pericardiotomy and pericardial stay suture 2/0 silk. 

   6.  Aortic purse string 3/0 T3 Tevdek followed by snugger. 

   7.  SVC purse string 4/0 CII followed by snugger IVC cannulae. 

   8.  Aortic cannulation with 11 No blade and aortic cannu­lation, connect the cannulae with arterial line. 

   9.  IVC purse string 4/0 with snugger and IVC cannulae, connect venous cannulae with venous line. 

10.  Cool the patient. 

11.  4/0 T3 Tevdek followed by cardioplegic cannulae.

12.  Aortic cross clamp, open LA with No. 11 long knife with long scissors. LA retractor, hard felt with valve sizer to take size. 9 sutures of 2/0 T3, Tevdek DA to repair the valve with felt. 32 or 36 Portex to check the valve. LA closure 3/0 prolene. 

13.  Decannulation, BP, heart rate, ECG maintained. 

14.  Pacing wires.

15.  Chest drainage tubes.

16.  Control hemostasis. 

17.  Sponge and instruments count.

18.  Sternal closure.

19.  Muscle and subcuticle closure.

20.  Dress with betadine.

Instruments

•   Cleaning tray 

•   Catheterization set 

•   Cardiac set 

•   OH special set 

•   OH vascular set 

•   OH water seal pkt. 

Special Instruments

•   Left atrial set

•   Mitral hooks 

•   11 No. knife long handle 

•   Valve sizers

•   Hard felt.

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