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Heart - Lung (Varna)

Mitral valve reoperations through right thoracotomy approach

Vili Pashev, Plamen Panayotov, Delyan Evrev, Zheko Naychov, Lilyana Mircheva, Emil Yordanov, Veselin Petrov


Cardiac surgery reoperations are related to an increased risk of rupture of heart structures, large vessels, and patent grafts during middle re-sternotomy due to adhesions around the heart and between the heart and the sternum. Right thoracotomy access is a good alternative to minimize possible complications in mitral valve redo surgery.

This report aims at presenting the results of two cases of redo-mitral valve replacement performed at the University Hospital "Lozenets" through right anterolateral thoracotomy access.

The first case is a 50-year-old woman with mechanical dysfunction of a mitral valve prosthesis with a high degree of obstruction, and the second is a 72-year-old male who has previously undergone left ventricle plastic due to aneurysm and mitral valve plasty.

In both patients, a computed tomographic study was performed before the operation showing the presence of adhesions between the sternum and heart. Both were operated on with a separate bronchial intubation with a Carlen's tube and right anterolateral thoracotomy at the 5th intercostal space. The mitral valve prosthesis was biological. No complications were observed during the surgery and in the postoperative period. Patients were discharged on the 17th and 14th postoperative days, respectively.


reoperation; mitral valve; right thoracotomy

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