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Rivista di Medicina Interna
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Panminerva Medica 1998 Giugno;40(2):94-7
Right thoracotomy as an alternative for redo mitral valve replacement and concomitant repair of the tricuspid valve
Terada Y., Mitsui T., Sakakibara Y., Tsutsui T., Okamura K., Jikuya T., Atsumi N., Shigeta O.
From the Department of Cardiovascular Surgery Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
Background. We report the results of a right thoracotomy for reoperation on the mitral valve plus concomitant procedures. Access to the aorta or to repair of other lesions by this approach is controversial.
Experimental design and setting. Retrospective study. Institutional practice (University of Tsukuba Hospital, Tsukuba, Japan).
Methods. Until 1995, 9 patients underwent right thoracotomy for mitral valve reoperation. The indication for this approach was no retrosternal space with the pericardium left open. Seven patients had deteriorated bioprosthesis, 1 periprosthetic valve leakage, and 1 re-stenosis. Four were associated with moderate tricuspid regurgitation. Operations were performed under fibrillation. Cardioplegia was used in 1.
Results. Through thoracotomy, 4 underwent mitral valve re-replacement, and 4 mitral valve re-replacement plus tricuspid annuloplasty. One was abandoned because of severe pleural adhesion. No neurological injury, or perioperative myocardial infarction occurred.
Conclusions. The right thoracotomy was an effective alternative to repeat sternotomy for redo mitral valve operation. Also, concomitant repair of the tricuspid valve could be safely done by this approach.