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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
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Pulmonary valve replacement through a left minithoracotomy: an alternate approach
Faisal H Cheema1, Elbert E Heng2, Atiq Rehman3
1University of Maryland School of Medicine, Baltimore, Maryland.
The Annals of Thoracic Surgery
|December 3, 2014
Summary
This case study details a rare isolated pulmonary valve endocarditis in a young woman caused by Staphylococcus aureus. Surgical pulmonary valve replacement via left minithoracotomy was successfully performed, offering a novel minimally invasive approach.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Endocarditis, an infection of the heart lining or valves, is uncommon on the pulmonary valve.
- Pulmonary valve endocarditis is often associated with specific risk factors, including intravenous drug use.
- Staphylococcus aureus is a common pathogen in infective endocarditis.
Observation:
- A 23-year-old woman with a history of oxycodone abuse presented with fever and Staphylococcus aureus bacteremia.
- Transesophageal echocardiography revealed a significant 3-cm vegetation on the pulmonary valve.
- Despite initial antibiotic treatment, fever persisted and vegetation size remained unchanged.
Findings:
- Surgical intervention was necessary due to persistent fever and embolic risk.
- A left minithoracotomy approach was utilized for pulmonary valve replacement.
- A bioprosthetic valve was implanted using warm cardiopulmonary bypass on a beating heart.
Implications:
- This case highlights a rare presentation of infective endocarditis.
- Minimally invasive pulmonary valve replacement via left minithoracotomy is a feasible surgical option.
- This approach may offer advantages for select patients with pulmonary valve endocarditis.
