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Related Experiment Videos

Mitral valve surgery through right thoracotomy.

F Calleja1, J L Martinez, N Gonzales De Vega

  • 1Department of Cardiovascular Surgery, Hospital Materno-Infantil Arroyo de los Angeles, Malaga, España.

The Journal of Cardiovascular Surgery
|December 1, 1996
PubMed
Summary
This summary is machine-generated.

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Right thoracotomy (RT) is a valuable approach for mitral valve surgery, especially in patients with prior sternotomies or mediastinitis. This technique offers excellent visualization, potentially making it ideal for mitral valve repair.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery

Background:

  • Right thoracotomy (RT) was re-established for mitral valve access due to technical reasons.
  • This approach has been utilized in 23 patients over two years.

Purpose of the Study:

  • To evaluate the efficacy and safety of right thoracotomy for mitral valve surgery.
  • To assess its utility in patients with prior sternotomies and mediastinitis.

Main Methods:

  • Intracardiac surgery performed with moderate hypothermia and controlled ventricular fibrillation.
  • Aorta remained unclamped in most cases, except for one instance of aortic incompetence requiring cross-clamping.
  • Procedures included mitral valve replacement, reattachment of leaking prostheses, and native valve repair.

Main Results:

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  • 14 patients underwent mitral valve replacement.
  • 5 leaking mitral prostheses were reattached, and 4 native valves were repaired.
  • Mortality was 9% (2 patients), unrelated to the surgical technique; no cases of air embolism occurred.

Conclusions:

  • Right thoracotomy is highly effective for mitral valve access, particularly in patients with multiple sternotomies, postoperative mediastinitis, or prior coronary artery bypass grafting.
  • The clear view of the mitral valve with an unclamped aorta suggests potential for elective mitral valve repair using this approach.