MP11. Concomitant Replacement of the Aortic, Mitral, and Tricuspid Valves
Presented During: Moderated E-Posters
MEDICAL COLLEGE OF GEORGIA
Augusta, GA
United States - Contact Me
Philip Coffey is a General Surgery resident at the Medical College of Georgia pursuing a fellowship in Cardiothoracic Surgery. He received his MD from the Medical University of South Carolina, and his BS in Biology from Wofford College. He was born in Macon, Georgia, and grew up in Spartanburg, South Carolina. Research interests include novel surgical therapies, optimization of current techniques with new technology, genetic factors in coronary artery bypass graft patency, and mechanisms of aortic aneurysm formation. In his free time Philip enjoys singing, martial arts, fishing, cooking, and Braves baseball. He and his wife Jesse are the proud parents of one daughter, Aida, who is 1 year old.
Thursday, May 4, 2023: 6:30 PM - Saturday, May 6, 2023: 2:29 AM
New York Hilton Midtown
Room: Grand Ballroom Foyer
Description
Objective:
To present our operative approach to a complex case with high mortality and how we minimize pump time and clamp time.
Case Video Summary:
We present a concomitant aortic valve replacement, mitral valve replacement, and tricuspid valve replacement in a 69 year old female with severe mitral regurgitation, severe tricuspid regurgitation, and moderate aortic insufficiency. We begin the case with a median sternotomy and bicaval venous cannulation. We then cross clamp, give antegrade, place an LV vent, and divide the aorta while giving retrograde cardioplegia. We excise the native aortic valve then give handheld antegrade cardioplegia. We then proceed to the mitral valve replacement. The chords of the anterior leaflet were too short and thickened to preserve, but we did preserve the posterior leaflet. We then replace the aortic valve, close the aorta, and remove the cross clamp. We then perform a tricuspid valve replacement beating heart. We close the right atrium, wean from bypass, and decannulate.
Conclusions:
In a case of this magnitude with high mortality, minimizing cross clamp time is critical and we believe this approach minimizes both bypass time and clamp time while providing optimal cardiac protection.
To present our operative approach to a complex case with high mortality and how we minimize pump time and clamp time.
Case Video Summary:
We present a concomitant aortic valve replacement, mitral valve replacement, and tricuspid valve replacement in a 69 year old female with severe mitral regurgitation, severe tricuspid regurgitation, and moderate aortic insufficiency. We begin the case with a median sternotomy and bicaval venous cannulation. We then cross clamp, give antegrade, place an LV vent, and divide the aorta while giving retrograde cardioplegia. We excise the native aortic valve then give handheld antegrade cardioplegia. We then proceed to the mitral valve replacement. The chords of the anterior leaflet were too short and thickened to preserve, but we did preserve the posterior leaflet. We then replace the aortic valve, close the aorta, and remove the cross clamp. We then perform a tricuspid valve replacement beating heart. We close the right atrium, wean from bypass, and decannulate.
Conclusions:
In a case of this magnitude with high mortality, minimizing cross clamp time is critical and we believe this approach minimizes both bypass time and clamp time while providing optimal cardiac protection.