Beating Heart Mitral Valve Replacement via Right Thoracotomy for Ischemic Mitral Valve Regurgitation after Coronary Artery Bypass Surgery

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Ischemic mitral valve regurgitation (n=1). Intervention: Beating heart mitral valve replacement via right thoracotomy. Primary outcome: Postoperative course and complications.

Kenta Zaikokuji; Akihiro Mizuno; Tatsuhito Ogawa; Jien Saito; Hisao Suda

doi:10.4326/jjcvs.47.235

September 15, 2018Japanese Journal of Cardiovascular SurgeryOpen Access

Beating Heart Mitral Valve Replacement via Right Thoracotomy for Ischemic Mitral Valve Regurgitation after Coronary Artery Bypass Surgery

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Key result

Beating heart mitral valve replacement via right thoracotomy was safely performed in a patient with prior CABG, avoiding graft injuries and resulting in discharge 7 days post-surgery without complications.

Key Points

To describe an operative approach using beating-heart mitral valve replacement via right thoracotomy to prevent graft injury and minimize surgical complications in a reoperative patient after coronary artery bypass grafting.
Evaluated a 69-year-old male with patent bypass grafts who developed severe ischemic mitral regurgitation following previous coronary artery bypass surgery (N=1).
Conducted endoscopic-assisted, beating-heart mitral valve replacement with bileaflet chordal preservation through a right thoracotomy.
Extubation was successfully accomplished on the day of surgery, and the patient was discharged without complications on postoperative day 7.
The right thoracotomy approach avoided dissection of patent bypass grafts, reducing bleeding risk and operative duration during redo cardiac surgery.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 69-year-old man with a history of coronary artery bypass grafting and severe ischemic mitral valve regurgitation who underwent beating heart mitral valve replacement via right thoracotomy.

I

Intervention

Beating-heart mitral valve replacement with preservation of both leaflets and chordae via right thoracotomy with endoscopic assistance

O

Outcome

Postoperative course and complications

Beating-heart mitral valve replacement via right thoracotomy is a feasible and safe option for re-do surgery after CABG to avoid graft injury.

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Implication

Offers potential alternative for re-do mitral surgery after CABG; hypothesis-generating and requires validation before broader use.

Abstract

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Cite This Study

Zaikokuji et al. (2018) conducted a case report in Ischemic mitral valve regurgitation (n=1). Beating heart mitral valve replacement via right thoracotomy was evaluated on Postoperative course and complications. Beating heart mitral valve replacement via right thoracotomy was safely performed in a patient with prior CABG, avoiding graft injuries and resulting in discharge 7 days post-surgery without complications.

synapsesocial.com/papers/6aa4078711a2517b84c62767 https://doi.org/10.4326/jjcvs.47.235

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Beating Heart Mitral Valve Replacement via Right Thoracotomy for Ischemic Mitral Valve Regurgitation after Coronary Artery Bypass Surgery

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Beating Heart Mitral Valve Replacement via Right Thoracotomy for Ischemic Mitral Valve Regurgitation after Coronary Artery Bypass Surgery

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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