The most common technique for surgeons to reach the heart is a mean sternotomy (vertically reducing the breastbone), however other incisions may be hired, which includes a left or right thoracotomy. After the heart is uncovered, the patient is put on a cardiopulmonary pass system, additionally called a heart–lung gadget. This device breathes for the affected person and pumps their blood around their frame – bypassing the heart – while the general practitioner replaces the heart valve. Next, an aortic clamp is placed on the aorta, and the heart is stopped (cardioplegia). Depending at the pathology of the mitral valve and general practitioner’s preference, various techniques can be used to get admission to the mitral valve. The interatrial groove technique involves incising the left atrium posterior to the interatrial groove. The transatrial indirect method is utilized whilst the left atrium is small. In this approach, the proper atrium is opened and another incision is made on the interatrial septum.
The valve is excised 4–5 mm from the annulus, leaving intact the connected chordae until they are calcified or in any other case diseased. The valve is changed by a mechanical or bioprosthetic valve. The alternative valve is sewn into the annulus with interrupted or horizontal mattress sutures with the pledgets at the atrial side. The atrial partitions are closed, taking care no longer to lure air inside the chambers of the coronary heart. The coronary heart is restarted, and the affected person is taken off the heart–lung machine.