PMID- 10709823
OWN - NLM
STAT- MEDLINE
DCOM- 20000329
LR  - 20220309
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 14
IP  - 2
DP  - 1999 Mar-Apr
TI  - Approach to the mitral valve through a right thoracotomy in potentially hazardous 
      reoperation.
PG  - 112-5
AB  - BACKGROUND: Repeat sternotomy for mitral valve surgery may be hazardous in some 
      patients. A right thoracotomy avoids the densely scarred area beneath the sternum 
      and provides adequate in-line exposure of the mitral valve. METHODS: Between 1994 
      and 1997, five patients were reoperated for a mitral valve or prosthesis 
      dysfunction through a right thoracotomy. Indications were three second 
      redo-mitral valve surgeries and two first redo, once in a patient with an aortic 
      prosthesis and once in a patient with patent aortocoronary grafts. The operation 
      was performed without clamping the ascending aorta in moderate hypothermic (four 
      patients) or normothermia (one patient). RESULTS: Exposure of the mitral valve 
      for replacement (four patients) or for repair of a paraprosthetic leak (one 
      patient) was optimal in all patients. Resumption of cardiac function occurred 
      rapidly after repair without specific support. Postoperative course was 
      uncomplicated. Blood loss ranged from 300 to 700 mL. Patients were discharged 
      from 7 to 12 days postoperatively. They are in New York Heart Association (NYHA) 
      functional Class I (four patients) and II (one patient), from 3 to 42 months 
      postoperatively. CONCLUSION: Right thoracotomy provides a direct "in the line of 
      vision" access to the mitral valve. Because complete de-airing of the heart is 
      difficult and respiratory function depressed after a right thoracotomy, this 
      approach seems suitable when technical difficulties are expected in sternal 
      reopening.
FAU - Pretre, R
AU  - Pretre R
AD  - Cardiovascular Surgery, University Hospital Zurich, Switzerland. 
      rene.pretre@chi.usz.ch
FAU - Ye, Q
AU  - Ye Q
FAU - Zund, G
AU  - Zund G
FAU - Turina, M I
AU  - Turina MI
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Reoperation
MH  - Thoracotomy
EDAT- 2000/03/10 09:00
MHDA- 2000/04/01 09:00
CRDT- 2000/03/10 09:00
PHST- 2000/03/10 09:00 [pubmed]
PHST- 2000/04/01 09:00 [medline]
PHST- 2000/03/10 09:00 [entrez]
AID - 10.1111/j.1540-8191.1999.tb00960.x [doi]
PST - ppublish
SO  - J Card Surg. 1999 Mar-Apr;14(2):112-5. doi: 10.1111/j.1540-8191.1999.tb00960.x.