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Mitral Valve Repair in Redo Cardiac Surgery
Author(s) -
Adams David H.,
Filsoufi Farzan,
Byrne John G.,
Karavas Alexandros N.,
Aklog Lishan
Publication year - 2001
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2001.tb01218.x
Subject(s) - medicine , thoracotomy , mitral valve repair , cardiology , surgery , artery , dissection (medical) , mitral valve replacement , mitral valve , bypass grafting , median sternotomy , aortic valve replacement , cardiopulmonary bypass , stenosis
A bstract An increasing number of patients are being referred for mitral valve repair in the redo cardiac surgery setting. The most common clinical scenarios involve prior coronary bypass surgery or aortic valve replacement, each presenting special challenges in terms of gaining valve exposure to enable repair while limiting dissection as much as possible. A right anterior thoracotomy approach is preferred in most patients, coupled with hypothermic fibrillatory arrest. A repeat sternotomy may be favored in select circumstances such as when there is a need for bypass grafting or moderate aortic insufficiency is present. Special attention to cannulation techniques, perfusion conditions, valve exposure, and de‐airing maneuvers are all important to ensure good clinical results. Using a tailored approach we have performed mitral valve repair in 22 patients with a patent left internal mammary artery graft following coronary artery bypass grafting between July 1992 and February 2000 with acceptable morbidity and low mortality.