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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Alternative approach for aortic valve replacement: in mediastinal deviation after right lobectomy
Kyokun Uehara1, Koji Ueyama, Hidehiro Ito
1Department of Cardiovascular Surgery & Cardiology, Kitano Hospital, Osaka 530-8480, Japan.
Texas Heart Institute Journal
|September 17, 2010
Summary
This study presents a modified T-shaped sternotomy technique for aortic valve replacement in patients with prior lung surgery. This approach offers excellent exposure and avoids thoracotomy, ensuring no postoperative respiratory complications.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
Background:
- Aortic valve replacement is a common procedure, but anatomical variations can complicate surgical access.
- Prior right lobectomy can alter thoracic anatomy, potentially impacting standard sternotomy approaches for aortic valve surgery.
Observation:
- Chest computed tomography revealed counterclockwise cardiac rotation in a patient with a history of right lobectomy.
- A modified median sternotomy with T-shaped incision provided adequate exposure of the ascending aorta, right atrium, and right upper pulmonary vein.
Findings:
- Aortic valve replacement was successfully performed using a T-shaped sternotomy without thoracotomy.
- The modified sternotomy technique facilitated excellent surgical exposure despite the patient's altered thoracic anatomy.
Implications:
- This T-shaped sternotomy technique is a viable alternative for aortic valve surgery in patients with post-lobectomy anatomical deviations.
- The described approach minimizes invasiveness and avoids potential respiratory complications associated with thoracotomy in this patient population.
