Key result
Right infra-axillary thoracotomy for high-risk redo mitral valve surgery achieves 100% uneventful outcomes without sternotomy.
Why the study?
A right infra-axillary thoracotomy offers excellent exposure of the mitral valve, prompting evaluation of this incision in high-risk patients undergoing redo mitral valve procedures.
Does right infra-axillary thoracotomy allow safe redo mitral valve surgery in high-risk patients?
Observational (n=32)
Does right infra-axillary thoracotomy allow safe redo mitral valve surgery in high-risk patients?
Right infra-axillary thoracotomy is a safe and feasible approach for redo mitral valve surgery in high-risk patients, avoiding the need for resternotomy.
Offers sternotomy avoidance in selected high-risk redo mitral patients; leaves open comparative safety and efficacy versus sternotomy.
BACKGROUND: A right infra-axillary thoracotomy can offer excellent exposure of the mitral valve. This study evaluated this incision for high-risk patients undergoing redo mitral valve procedures. METHODS: Of a series of 189 patients who had redo mitral valve surgery, 32 were reoperated via vertical infra-axillary thoracotomy based on previous aortic valve replacement, dense adhesion, location of patent bypass grafts, and peripheral vascular disease. RESULTS: Sternotomy was avoided in all cases. The mitral valve was replaced in 22 patients and repaired in 10 patients; left atrial folding was performed in 6 patients. All patients had uneventful outcomes and normal valve function during follow-up. CONCLUSIONS: Reoperative mitral valve surgeries can be performed safely using right infra-axillary thoracotomy in certain patients. The procedure offers excellent exposure of the mitral valve and minimizes the need for cardiac dissection, thus reducing injury risk. Avoiding a high risk of resternotomy increases patient comfort and safety.
No takes yet. Share an insight, caveat, or question.
Cao et al. (2020) conducted an observational in High-risk reoperative mitral valve disease (n=32). Right infra-axillary thoracotomy was evaluated on Uneventful outcomes and normal valve function. Right infra-axillary thoracotomy for redo mitral valve surgery avoided sternotomy in all 32 high-risk patients, resulting in uneventful outcomes and normal valve function during follow-up.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: