Related Links
Statistics
| Number of Journals | 8 |
| Number of Issues | 55 |
| Number of Articles | 403 |
| Article View | 145,345 |
| PDF Download | 99,591 |
Emergency operation of redo second and third mitral valve regurgitation in a patient with a history of the mitral valve prosthesis, coronary artery bypass graft surgery, and moderate aortic regurgitation: a case presentation | ||
| Cardiovascular Biomedicine | ||
| Volume 2, Issue 1, September 2022, Pages 1-5 PDF (448.5 K) | ||
| Document Type: case report | ||
| DOI: 10.18502/cbj.v1i2.10586 | ||
| Authors | ||
| Ahmadali Khalili; Amir Faravan; Razieh Parizad* | ||
| Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran | ||
| Abstract | ||
| Redo cardiac surgery is usually more complex than initial surgery and has a higher risk of mortality due to the risks associated with sternotomy. Thoracotomy is a procedure through which easy access to the heart and valves is possible, taking less time. There is no need to release the adhesions of the previous operation. In addition, there is no possibility of heart rupture and unstable hemodynamics in the second CABG operation. Safe peripheral Cardiopulmonary bypass (CPB) access and right thoracotomy are preferred in patients with unstable hemodynamics with a history of CABG and mitral valve replacement (MVR) surgery. A 60 -year old man with a history of prosthetic MVR, CABG, and right-hand paresis due to cerebrovascular accident (CVA) was referred to Madani Hospital in Tabriz, Iran (2020). Transthoracic echocardiography (TTE) revealed signs of severe dysfunction of the prosthetic mitral valve (PMV). Whereas, on anticoagulation, a left ventricular ejection fraction (LVEF) was about 40%, and the patient had mild to moderate aortic regurgitation (AI). The patient underwent an emergency redo MVR operation using the thoracotomy techniques and coronary intervention (hybrid procedure). After two weeks, TTE showed a decreased mobility of one PMV leaflet, and the patient did not respond to full anticoagulation. Therefore, the third surgery was performed. | ||
| Keywords | ||
| Thoracotomy; Coronary artery bypass; Prosthetic valve malfunction; Reoperation | ||
| References | ||
|
1.Launcelott S, Ouzounian M, Buth KJ et al. Predicting in-hospital mortality after redo cardiac operations: development of a preoperative scorecard. Ann Thorac Surg. 2012;94(3):778-84.
2.Botta L, Cannata A, Fratto P, et al. The role of the minimally invasive beating heart technique in reoperative valve surgery. J Card Surg. 2012; 27(1):24-8.
3.Greco R, Muretti M, Djordjevic J, et al. Surgical complexity and outcome of patients undergoing re-do aortic valve surgery. Open Heart. 2020; 15; 7(1):e001209.
4. Frederick JR, Woo YJ. Thoracoabdominal aortic aneurysm. Ann Cardiothorac Surg. 2012; 1(3):277.85.
5. Cao H, Zhou Q, Fan F, Xue Y, Pan J, Wang D. Right anterolateral thoracotomy: an attractive alternative to repeat sternotomy for high-risk patients undergoing reoperative mitral and tricuspid valve surgery. J Cardiothorac Surg. 2017; 12(1):85.
6. Romano MA, Haft JW, Pagani FD, Bolling SF. Beating heart surgery via right thoracotomy for reoperative mitral valve surgery: a safe and effective operative alternative. J Thorac Cardiovasc Surg. 2012; 144(2):334-9.
7. Grossi EA, Ribakove G, Schwartz DS, Galloway AC, Colvin SB. Port-access approach for minimally invasive mitral valve surgery. Oper Techn in Cardiac and Thoracic Surg. 1998;3(1):32-46.
8.Harris AM, Shawkat S, Bailey JS. The use of an endotracheal tube for cannulation of left superior vena cava via coronary sinus for repair of a sinus venosus atrial septal defect. Br Heart J. 1987; 58(6):676-7.
9.Nishi H, Mitsuno M, Yamamura M, et al. Safe approach for redo coronary artery bypass grafting–preventing injury to the patent graft to the left anterior descending artery. Ann Thorac Cardiovasc Surg. 2010; 16(4):253-8.
10. Ward AF, Grossi EA, Galloway AC. Minimally invasive mitral surgery through right mini-thoracotomy under direct vision. J Thorac Dis. 2013;5 Suppl 6(Suppl 6):S673-9.
11.Grossi EA, LaPietra A, Ribakove GH, et al. Minimally invasive versus sternotomy approaches for mitral reconstruction: comparison of intermediate-term results. J Thorac Cardiovasc Surg. 2001; 121(4):708-13.
12.Davierwala PM, Seeburger J, Pfannmueller B, et al. Minimally invasive mitral valve surgery:“The Leipzig experience”. Ann Cardiothorac Surg. 2013;2(6):744.
13.Sengupta A, Yazdchi F, Alexis SL, et al. Reoperative Mitral Surgery Versus Transcatheter Mitral Valve Replacement: A Systematic Review. J Am Heart Assoc. 2021; 10(6):e019854.
14.Kawamura M, Finkbinder PJ, Morris RJ. Reoperative mitral valve replacement via right mini-thoracotomy with ventricular fibrillatory arrest for a patient with severely calcified aortic homograft. J Surg Case Rep. 2019; 2019(11):rjz285.
| ||
|
Statistics Article View: 253 PDF Download: 150 |
||