holds the Dacron patch, extends from the septum. Dor explicates this procedure in detail. When the lesion is placed on the posterolateral wall of the heart, a triangular patch is used and stabilized by the posterior mitral annulus. This placement of the lesion allows for mitral valve replacement to be easily conducted by the transventricular approach. (The surgeon does not have to incise the atrium, rather can replace the valve through the already incised ventricle.) It is recommended that the patient be placed on a mild anti-coagulant post operation to reduce the risk of blood clots. Some surgeons suggest the use of stronger anti-coagulants. Disadvantages The disadvantage to the Dor procedure is that it places synthetic tissue inside the LV cavity. However, it is possible to replace the Dacron patch with autologous tissue. The surgeon can make a semicircular patch, mobilized with a septal hinge, out of the endocardial scar or use autologous patches of the pericardium. Results The Dor procedure requires a hospital stay of approximately 8 days, which is only one day longer than CABG, and the early mortality rate is about 5.6%. Post-operation, the patient does not have any lifestyle constraints other than those associated with CABG. There is a 4% chance the patient will require another cardiac operation: 18% of patients who underwent CABG had recurrent heart failure. Because the Dor procedure restores the left ventricle to its correct, elliptical orientation, it results in a mean ejection fraction increase of 12.5%. This number continues to improve over the patient’s lifetime, and patients can expect to live an extra 4–10 years, which is 3.3% longer than CABG alone with virtually no extra risk. References Further reading Cardiac surgery