PMID- 15199722
OWN - NLM
STAT- MEDLINE
DCOM- 20040722
LR  - 20080310
IS  - 0043-3144 (Print)
IS  - 0043-3144 (Linking)
VI  - 53
IP  - 2
DP  - 2004 Mar
TI  - Initial experience with beating-heart single valve replacement surgery at the 
      University Hospital of the West Indies, Kingston, Jamaica.
PG  - 109-12
AB  - The objective of this study was to examine the consequences of performing single 
      cardiac valve replacement procedures utilizing a beating-heart technique on 
      typical patients presenting to the cardiothoracic surgery service for aortic or 
      mitral valve replacement. Beating heart aortic (4) or mitral valve (1) 
      replacement was performed on patients from July 2000 to November 2002. A 
      stratified sample of five patients who underwent standard arrested-heart single 
      valve replacement procedures between April 1997 and November 2002 was selected 
      for retrospective comparison with the beating-heart group. Operative and 
      post-operative variables were compared between the two groups of patients and 
      subjected to statistical analysis. There was no statistical difference between 
      the two groups with respect to age, pre- or post-operative New York Heart 
      Association (NYHA) scores, cardiopulmonary bypass time, aortic cross-clamp time, 
      intra-operative blood transfusion, or post-operative hospital stay. 
      Post-operatively, in the beating heart group, ventilation time, mediastinal blood 
      loss and requirements for inotropic drugs were significantly reduced (p = 
      0.0054), p = 0.0019 and 0 = 0.02 respectively) compared to the arrested-heart 
      group. Single cardiac valve replacement surgery utilizing a beating heart 
      technique may offer benefits to patients over traditional arrested-heart surgery. 
      Post-operative blood loss, inotrope requirements and ventilation times are 
      significantly reduced, possibly resulting in better recovery and potentially 
      fewer complications in the post-operative period. There may be cost benefits, 
      important in the context of healthcare delivery in developing nations. These 
      early results suggest the need for a regional prospective randomized trial to 
      compare beating-heart single valve replacement surgery with traditional 
      techniques.
FAU - Ramphal, P S
AU  - Ramphal PS
AD  - Division of Cardiothoracic Surgery, Department of Surgery, Radiology, Anaesthesia 
      and Intensive Care, Faculty of Medical Sciences, University of the West Indies, 
      Kingston 7, Jamaica, West Indies. pabloram@cwjamaica.com
FAU - Irvine, R W
AU  - Irvine RW
FAU - Wierenga, A
AU  - Wierenga A
FAU - Scarlett, M
AU  - Scarlett M
FAU - McGaw, C D
AU  - McGaw CD
LA  - eng
PT  - Journal Article
PL  - Jamaica
TA  - West Indian Med J
JT  - The West Indian medical journal
JID - 0417410
SB  - IM
MH  - Adult
MH  - Aortic Valve/surgery
MH  - Chi-Square Distribution
MH  - Female
MH  - Heart Valve Diseases/*surgery
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Hospitals, University
MH  - Humans
MH  - Jamaica
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2004/06/18 05:00
MHDA- 2004/07/23 05:00
CRDT- 2004/06/18 05:00
PHST- 2004/06/18 05:00 [pubmed]
PHST- 2004/07/23 05:00 [medline]
PHST- 2004/06/18 05:00 [entrez]
PST - ppublish
SO  - West Indian Med J. 2004 Mar;53(2):109-12.