PMID- 20478046
OWN - NLM
STAT- MEDLINE
DCOM- 20100729
LR  - 20211020
IS  - 1749-8090 (Electronic)
IS  - 1749-8090 (Linking)
VI  - 5
DP  - 2010 May 17
TI  - Mitral valve replacement via right thoracotomy approach for prevention of 
      mediastinitis in a female patient with long-term uncontrolled diabetes mellitus: 
      a case report.
PG  - 38
LID - 10.1186/1749-8090-5-38 [doi]
AB  - A 76-year-old woman with a history of percutaneous transvenous mitral 
      commissurotomy and repeated hospital admissions due to heart failure was referred 
      for an operation for severe mitral valve stenosis. She presented with 
      hypertension, hyperlipidemia and cerebral infarction with stenosis of right 
      internal carotid artery, retinopathy, neuropathy and nephropathy caused by 
      long-term uncontrolled diabetes mellitus, hemoglobin A1c of 9.4%, and New York 
      Heart Association (NYHA) functional classification of 3/4. Echocardiography 
      revealed severe mitral valve stenosis with mitral valve area of 0.6 cm2, moderate 
      tricuspid valve regurgitation, and dilatation of the left atrium. Taking into 
      consideration the NYHA functional classification and severe mitral valve 
      stenosis, an immediate surgical intervention designed to prevent mediastinitis 
      was performed. The approach was via the right 4th thoracotomy, as conventional 
      sternotomy would raise the risk of mediastinitis. Postoperative antibiotics were 
      administered intravenously for 2 days, and signs of infection were not 
      recognized.In patients with long-term uncontrolled diabetes mellitus, mid-line 
      sternotomy can easily cause mediastinitis. The choice of operative approach plays 
      an important role in preventing this complication. In this report, the importance 
      of the conventional right thoracotomy for prevention for mediastinitis is 
      reviewed.
FAU - Fukunaga, Naoto
AU  - Fukunaga N
AD  - Department of Cardiovascular surgery, Kobe City Medical Center General Hospital, 
      4-6 Minatojimanakamachi, Chuo-ku, Kobe, Hyogo 650-0046, Japan. 
      naotowakimachi@hotmail.co.jp
FAU - Hashimoto, Takashi
AU  - Hashimoto T
FAU - Ozu, Yasuhisa
AU  - Ozu Y
FAU - Komori, Shigeru
AU  - Komori S
FAU - Shomura, Yu
AU  - Shomura Y
FAU - Fujiwara, Hiroshi
AU  - Fujiwara H
FAU - Nasu, Michihiro
AU  - Nasu M
FAU - Okada, Yukikatsu
AU  - Okada Y
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20100517
PL  - England
TA  - J Cardiothorac Surg
JT  - Journal of cardiothoracic surgery
JID - 101265113
SB  - IM
MH  - Aged
MH  - *Diabetes Complications
MH  - Female
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Mediastinitis/etiology/*prevention & control
MH  - Minimally Invasive Surgical Procedures
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Stenosis/*complications/surgery
MH  - Postoperative Complications/*prevention & control
MH  - *Thoracotomy
PMC - PMC2880967
EDAT- 2010/05/19 06:00
MHDA- 2010/07/30 06:00
PMCR- 2010/05/17
CRDT- 2010/05/19 06:00
PHST- 2009/11/19 00:00 [received]
PHST- 2010/05/17 00:00 [accepted]
PHST- 2010/05/19 06:00 [entrez]
PHST- 2010/05/19 06:00 [pubmed]
PHST- 2010/07/30 06:00 [medline]
PHST- 2010/05/17 00:00 [pmc-release]
AID - 1749-8090-5-38 [pii]
AID - 10.1186/1749-8090-5-38 [doi]
PST - epublish
SO  - J Cardiothorac Surg. 2010 May 17;5:38. doi: 10.1186/1749-8090-5-38.