New Replacement of a Thrombosed Mitral Valve via Right Anterolateral Thoracotomy in a Patient with Coronary Artery By-Pass Graft and Functioning Internal Mammary Artery Graft

A 49-year-old male, who had undergone mitral valve replacement with mechanical cardiac valve and coronary arterial by-pass grafting six years previously, was admitted to our hospital with acute dyspnea. Transesophageal echocardiography revealed that one of the leaflets of the prosthetic valve was entirely immobilized in the closed position, and an immobile soft tissue mass was detected on the ventricular side of the obstructed leaflet. We performed re-replacement using a 29-mm mechanical prosthetic St. Jude valve under deep hypothermic circulatory arrest via right atrial thoracotomy. Postoperative course was uneventful, and the patient was discharged with oral anticoagulant therapy on day 7 postoperatively.

New Replacement of a Thrombosed Mitral Valve via Right Anterolateral Thoracotomy in a Patient with Coronary Artery By-Pass Graft and Functioning Internal Mammary Artery Graft

A 49-year-old male, who had undergone mitral valve replacement with mechanical cardiac valve and coronary arterial by-pass grafting six years previously, was admitted to our hospital with acute dyspnea. Transesophageal echocardiography revealed that one of the leaflets of the prosthetic valve was entirely immobilized in the closed position, and an immobile soft tissue mass was detected on the ventricular side of the obstructed leaflet. We performed re-replacement using a 29-mm mechanical prosthetic St. Jude valve under deep hypothermic circulatory arrest via right atrial thoracotomy. Postoperative course was uneventful, and the patient was discharged with oral anticoagulant therapy on day 7 postoperatively.

___

  • 1. Holman WL, Goldberg SP, Early LJ, McGiffin DC, Kirklin JK, Cho DH et al. Right thoracotomy for mitral reoperation: analysis of technique and outcome. Ann Thorac Surg 2000; 70: 1970-3.
  • 2. Antunes MJ. Techniques of valvular re-operation. Eur J Cardiothorac Surg 1992; 6 Suppl 1: S54-7; discussion S58.
  • 3. Steimle CN, Bolling SF. Outcome of reoperative valve surgery via right thoracotomy. Circulation 1996; 94 (9 Suppl): II 126-8.
  • 4. Praeger PI, Pooley RW, Moggio RA, Somberg ED, Sarabu MR, Reed GE. Simplified method for re-operation on the mitral valve. Ann Thorac Surg 1989; 48: 835-7.
  • 5. Byrne JG, Aranki SF, Adams DH, Rizzo RJ, Couper GS, Cohn LH. Mitral valve surgery after previous CABG with functioning IMA grafts. Ann Thorac Surg 1999; 68: 2243-7.
  • 6. Byrne JG, Karavas AN, Adams DH, Aklog L, Aranki SF, Filsoufi F et al. The preferred approach for mitral valve surgery after CABG: right thoracotomy, hypothermia and avoidance of LIMA-LAD graft. J Heart Valve 2001; 10: 584-90.
  • 7. Braxton JH, Higgins RS, Schwann TA, Sanchez JA, Dewar ML, Kopf GS et al. Reoperative mitral valve surgery via right thoracotomy: decreased blood loss and improved hemodynamics. J Heart Valve Dis 1996; 5: 463.
  • 8. Thompson MJ, Behranwala A, Campanella C, Walker WS, Cameron EW. Immediate and long-term results of mitral prosthetic replacement using a right thoracotomy beating heart technique. Eur J Cardiothorac Surg 2003; 24: 47-51.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK