Related Experiment Video

Updated: Jun 20, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

[Reoperation through right thoracotomy for mitral regurgitation after coronary artery bypass grafting; report of a

Takuya Miura1, M Sakaki, T Yasuoka

  • 1Department of Cardiovascular Surgery, Kansai Rosai Hospital, Amagasaki, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 22, 2009
PubMed

Insights

This study highlights a minimally invasive approach for mitral valve replacement in patients with prior coronary artery bypass grafting (CABG). Right anterolateral thoracotomy offers a safe alternative to sternotomy, preserving bypass grafts.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Repair and Replacement
  • Minimally Invasive Cardiac Surgery

Background:

  • Severe mitral regurgitation can occur years after coronary artery bypass grafting (CABG).
  • Previous CABG presents challenges for subsequent cardiac surgeries due to graft proximity and risk of injury.

Observation:

  • A 53-year-old male patient with severe mitral regurgitation post-CABG underwent mitral valve replacement.
  • Coronary arteriography confirmed all bypass grafts (left internal thoracic artery and saphenous veins) were patent.
  • Right anterolateral thoracotomy was selected over median sternotomy to minimize risk to bypass grafts.

Findings:

  • Mitral valve replacement was successfully performed via right anterolateral thoracotomy under moderate hypothermia and ventricular fibrillation, without aortic cross-clamping.
  • The patient experienced an uneventful postoperative recovery.
  • This approach demonstrated feasibility and safety in managing mitral regurgitation in a patient with prior CABG.

Implications:

  • Right anterolateral thoracotomy may be a superior surgical approach for mitral valve surgery in patients with a history of CABG.
  • This technique potentially reduces the risk of injury to coronary bypass grafts compared to traditional sternotomy.
  • Further studies are warranted to establish the long-term benefits and broader applicability of this minimally invasive strategy.

More Related Videos

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Related Concept Videos

Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation IV: Nursing Management01:28

Mitral Regurgitation IV: Nursing Management

Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...