An approach to mitral valve surgery by a T-shaped mini-sternotomy with functioning bilateral internal thoracic artery grafts.
We herein report successful surgical treatment of mitral valve regurgitation in a 49-year-old man. He was admitted to our hospital due to acute aggravation of dyspnea on effort. He had a surgical history of coronary artery bypass grafting with bilateral internal thoracic artery grafts. A transthoracic echocardiogram showed severely decreased cardiac function and severe mitral regurgitation due to anterolateral mitral valve leaflet prolapse. Computed tomography showed the right internal thoracic artery running over the front of the aorta to the left circumflex artery. To avoid injury to the functioning grafts during median sternotomy, we chose to perform an inferior T-shaped mini-sternotomy. The surgical field was sufficient to perform mitral valve replacement with a mechanical prosthetic valve under fibrillatory arrest. The grafts were neither dissected nor clamped, and access to the aorta and mitral valve was excellent.
Takahashi
Yosuke
Y
Department of Cardiovascular Surgery, Fukui Cardiovascular Center, 2-228 Shinho, Fukui 910-0833, Japan.
Tsutsumi
Yasushi
Y
Monta
Osamu
O
Kato
Yasuyuki
Y
Kohshi
Keitaro
K
Sakamoto
Tomohiko
T
Ohashi
Hirokazu
H
D001026:Coronary Artery Bypass / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D056346:Sternotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome