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Updated: May 23, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Hybrid Perventricular Venus P-Valve Implantation Via Mini-Thoracotomy in a Patient With Mechanical Tricuspid Valve
Alper Guzeltas1, Selman Gokalp1, Sertac Haydin2
1Department of Pediatric Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Saglik Bilimleri University, Istanbul, Turkey.
Background:
Chronic severe pulmonary regurgitation following repair of right ventricular outflow dysfunction may result in progressive right ventricular dilatation, heart failure, and arrhythmias. In patients with a complex surgical history, particularly those with mechanical tricuspid valve prostheses, standard transvenous access for pulmonary valve implantation can be technically challenging and carries risks for prosthetic valve injury.
Case Summary:
We report a successful hybrid perventricular Venus P-Valve implantation via left mini-thoracotomy in a 29-year-old man with 2 prior cardiac surgeries, mechanical mitral and tricuspid valves. The procedure was performed on the beating heart without cardiopulmonary bypass, avoiding the risks of a third open-heart surgery.
Discussion:
This case highlights the advantages of a hybrid perventricular pulmonary valve implantation strategy in patients with a mechanical tricuspid valve.
Take-Home Message:
Hybrid perventricular access can expand transcatheter self-expanding pulmonary valve options in selected high-risk redo patients with a mechanical tricuspid valve and enlarged right ventricular outflow tract.
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