Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery
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 patient...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-09-01
|
| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13019-017-0645-x |
| _version_ | 1819070946234859520 |
|---|---|
| author | Hailong Cao Qing Zhou Fudong Fan Yunxing Xue Jun Pan Dongjin Wang |
| author_facet | Hailong Cao Qing Zhou Fudong Fan Yunxing Xue Jun Pan Dongjin Wang |
| author_sort | Hailong Cao |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T17:14:01Z |
| format | Article |
| id | doaj.art-dfc5c938496d4bd9899c3f1d0611067f |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-21T17:14:01Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-dfc5c938496d4bd9899c3f1d0611067f2022-12-21T18:56:20ZengBMCJournal of Cardiothoracic Surgery1749-80902017-09-011211510.1186/s13019-017-0645-xRight anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgeryHailong Cao0Qing Zhou1Fudong Fan2Yunxing Xue3Jun Pan4Dongjin Wang5Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing, University Medical SchoolDepartment of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing, University Medical SchoolDepartment of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing, University Medical SchoolDepartment of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing, University Medical SchoolDepartment of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing, University Medical SchoolDepartment of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing, University Medical SchoolAbstract 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.http://link.springer.com/article/10.1186/s13019-017-0645-xRight anterolateral thoracotomyReoperationMitral and tricuspid valve surgeryHigh-risk |
| spellingShingle | Hailong Cao Qing Zhou Fudong Fan Yunxing Xue Jun Pan Dongjin Wang Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery Journal of Cardiothoracic Surgery Right anterolateral thoracotomy Reoperation Mitral and tricuspid valve surgery High-risk |
| title | Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery |
| title_full | Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery |
| title_fullStr | Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery |
| title_full_unstemmed | Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery |
| title_short | Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery |
| title_sort | right anterolateral thoracotomy an attractive alternative to repeat sternotomy for high risk patients undergoing reoperative mitral and tricuspid valve surgery |
| topic | Right anterolateral thoracotomy Reoperation Mitral and tricuspid valve surgery High-risk |
| url | http://link.springer.com/article/10.1186/s13019-017-0645-x |
| work_keys_str_mv | AT hailongcao rightanterolateralthoracotomyanattractivealternativetorepeatsternotomyforhighriskpatientsundergoingreoperativemitralandtricuspidvalvesurgery AT qingzhou rightanterolateralthoracotomyanattractivealternativetorepeatsternotomyforhighriskpatientsundergoingreoperativemitralandtricuspidvalvesurgery AT fudongfan rightanterolateralthoracotomyanattractivealternativetorepeatsternotomyforhighriskpatientsundergoingreoperativemitralandtricuspidvalvesurgery AT yunxingxue rightanterolateralthoracotomyanattractivealternativetorepeatsternotomyforhighriskpatientsundergoingreoperativemitralandtricuspidvalvesurgery AT junpan rightanterolateralthoracotomyanattractivealternativetorepeatsternotomyforhighriskpatientsundergoingreoperativemitralandtricuspidvalvesurgery AT dongjinwang rightanterolateralthoracotomyanattractivealternativetorepeatsternotomyforhighriskpatientsundergoingreoperativemitralandtricuspidvalvesurgery |