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Published on: March 26, 2018
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Left posterolateral thoracotomy: an alternative approach for pulmonary valve replacement
François Roubertie1, Roland Henaine2, Xavier Roques1
1Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France.
The Annals of Thoracic Surgery
|February 4, 2014
Summary
Redo median sternotomy for pulmonary valve replacement in adults with repaired tetralogy of Fallot poses risks. A left posterolateral thoracotomy approach offers a safer, more versatile alternative for this complex cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Adult Congenital Heart Surgery
Background:
- Pulmonary valve replacement is common in adults with repaired Tetralogy of Fallot.
- Redo median sternotomy is the standard surgical approach.
- Dilated ascending aorta, often adherent, increases risk during sternal reentry.
Observation:
- A case of adult Tetralogy of Fallot repair requiring pulmonary valve replacement.
- The patient had a dilated ascending aorta and required transannular patch excision and pulmonary artery enlargement.
- A left posterolateral thoracotomy was utilized for the surgical procedure.
Findings:
- The left posterolateral thoracotomy approach was demonstrated to be safe and efficient.
- This approach provided greater surgical flexibility compared to anterior thoracotomy.
- Minimally invasive techniques can be effective in complex adult congenital heart surgery.
Implications:
- Left posterolateral thoracotomy may be a preferred alternative to sternotomy for specific pulmonary valve replacement cases.
- This approach can mitigate risks associated with sternal reentry in patients with aortic dilation.
- Further research into minimally invasive strategies for adult congenital heart disease is warranted.
Keywords:
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