Successful Right Atrial Approach Mitral Valve [At Lilavati Hospital]

Dr. Pavan Kumar, Dr. S Borkar, Dr. Amit Modi, Dr. N. Kothari, Dr.Asmita Hegde

Department Of Cardiac Surgery

A 50yr old lady was admitted in Lilavati Hospital with symptoms of breathlessness on exertion on March 13,2004. Investigations suggested that she had tight calcific Mitral stenosis with MVA of 0.9 cm2 on Echocardiography with normal LA size. Coronary angiography showed 90% obstruction in LAD vessel.

She underwent CABG + Mitral Valve replacement successfully on March 16,2004. As her cardiac parameters were normal mitral valve was approached through right atriotomy and inter atrial septum.This trans septal approach opens left atrium very near to Mitral valve which can be easily seen and operated upon. Repair & replacement by new prosthesis insertion is difficult task with small or normal sized left atrium specially when new prosthesis is required for a grown up adult. Customary left atrial approach is difficult to adopt with high chances of getting incision line extending behind SVC which is difficult to repair.

This modified approach is safe for mitral valve replacement or repair as demonstrated by Dr. Pavan Kumar the heart surgeon at Lilavati Hospital in this case.