Internally Reviewed The heart is exposed through a median sternotomy and anterior pericardiotomy. Venous drainage for cardiopulmonary bypass is obtained utilizing separate superior and inferior vena caval cannulae. The arterial return is directed into the distal ascending aorta.
Myocardial protection is afforded by a combination of antegrade and retrograde cardioplegia.
The mitral valve is exposed through a left atriotomy that is performed immediately adjacent to the atrial septum. The atrial septum is retracted anteriorly to facilitate visualization of the mitral valve. This particular mitral valve had thickened, fibrotic leaflets with dense calcification along the lateral aspect of the posterior leaflet. The calcification extended into the mitral annulus. The mitral valve was excised in its entirety including the subvalvular apparatus.