1. Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery.
- Author
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Hailong Cao, Qing Zhou, Fudong Fan, Yunxing Xue, Jun Pan, Dongjin Wang, Cao, Hailong, Zhou, Qing, Fan, Fudong, Xue, Yunxing, Pan, Jun, and Wang, Dongjin
- Subjects
THORACOTOMY ,REOPERATION ,MITRAL valve surgery ,TRICUSPID valve surgery ,HEART valve surgery ,MORTALITY ,THORACIC surgery ,CARDIAC surgery ,HEART valve diseases ,SURGICAL complications ,SURVIVAL ,DISEASE incidence - Abstract
Background: Reoperative cardiac valve surgery via sternotomy is associated with a substantial morbidity and mortality. This study evaluated the right anterolateral thoracotomy for high-risk patients undergoing mitral and tricuspid valve redo procedures.Methods: Out of a series of 173 patients undergoing redo cardiac valve surgery, 24 patients were reoperative via the right anterolateral thoracotomy as the high-risk group on the basis of the proximity of the heart and great vessels to the sternum and the presence and location of patent bypass grafts.Results: In all cases, sternotomy was avoided. The mitral valve and tricuspid valve were replaced in 4 and 19 patients and repaired in 1 and 2 patients, respectively. Moreover, left atrial folding was performed in 5 patients. Mortality was 8.3%. All other patients had uneventful outcomes and normal valve function at follow-up.Conclusions: Reoperative cardiac valve surgery can be performed safely using the right anterolateral thoracotomy in high-risk patients. It offers enough exposure. It minimizes the need for cardiac dissection, and thus, the risk for injury. Avoiding a high-risk resternotomy increases patients comfort and safety of redo mitral and tricuspid valve surgery. [ABSTRACT FROM AUTHOR]- Published
- 2017
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