Cardiovascular Disorders cardiovascular disorders are one of

Cardiovascular disorders are one of the leading causes of death in the United States, and although the incidence of rheumatic heart disease has declined significantly, the incidence of valve disease is still one of the three major cardiovascular disorders encountered, resulting in more than 200,000 heart valve replacements or repairs worldwide each year (Brown, 1998). Mitral valve replacement surgery can be performed using mechanical valves, tissue valves, or homografts (Strong, 2004). Mechanical grafts are the most reliable and durable of the three grafts, but require the patient to take blood thinners, and have regular blood work followup. Tissue grafts made from other biological tissues operate in a similar manner to human valves, and so blood thinners are not needed, but they usually have to be replaced after about 15 years. Homografts from donated human hearts cause less risk of infection and also do not require the use of blood thinners, but involve a more complex replacement surgical technique.

Mitral valve prolapse occurs when the mitral valve does not open and close properly and blood may leak backward into the left atrium (Papp, 2001). The changes occurring in the valve are brought about by the rapid proliferation of cells from the middle layer of the valve, pressing on the outer valve layer and causing it to weaken and resulting in a prolapse into the left atrium. In many cases, the disease in innocuous, but in severe cases, repair or repl

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diac movement and improving surgical access. Monitoring systems include a thermodilution pulmonary artery catheter, an arterial line, an electrocardiogram, and temperature. A single port is made for access to the heart, and a second one for the thorascope. Once the right lung is inflated, surgical instruments are inserted and the pericardium is opened. The catheters for the mitral valve replacement system are placed using fluoroscopy and TEE guidance. The endovascular pulmonary artery venting catheter is passed via a jugular vein into the pulmonary artery to decompress the heart, and the coronary sinus cardioplegia catheter positioned in the coronary sinus to occlude the coronary sinus and deliver the cardioplegia solution for cooling and arresting the heart. The endovascular triple-lumen balloon-tipped catheter is positioned through the femoral artery, and its tip is position fluoroscopically in the ascending aorta. The distal end is connected to the balloon-inflation and aortic root pressure-monitoring lines. The expanded balloon blocks blood flow in the aorta. Cardioplegia solution is infused, and the surgeon obtains access to the mitral valve to repair or replace the valve (Fitzgerald, 1998). The annulus is size

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