title: [Investigation of the outcomes and complications in right thoracotomy approach for mitral valve reoperation].
abstract: BACKGROUND
  Right thoracotomy is an alternative surgical technique for mitral valve reoperation. The purpose of this study is to determine whether right thoracotomy for mitral valve reoperation affects its perioperative outcomes and complications.
  
  
  METHODS
  We investigated the perioperative events in consecutive mitral valve reoperations between January 2006 and November 2009. Demographic, intraoperative and postoperative data were collected and analyzed retrospectively.
  
  
  RESULTS
  Five right thoracotomy cases and 22 repeated sternotomy cases were included. Thoracotomy group needed more platelet transfusion (median, 20 units in thoracotomy; 10 units in sternotomy; P=0.047). We had a higher frequency of adrenaline administration (60% in thoracotomy; 4.6% in sternotomy; P=0.005) and needed more doses of dobutamine in thoracotomy group (median, 16.0 microg x kg(-1) x min(-1) in thoracotomy ; 7.5 microg x kg(-1) x min(-1) in sternotomy; P=0.037) to wean them from cardiopulmonary bypass. Right thoracotomy did not reduce cardiopulmonary bypass time (median, 265 min in thoracotomy ; 199 min in sternotomy; P=0.126). We experienced two serious complications requiring reoperation in thoracotomy group, but diagnosed them with intraoperative transesophageal echocardiography.
  
  
  CONCLUSIONS
  When we choose right thoracotomy for mitral valve reoperation, we should prepare more blood products and inotropic agents and should evaluate cardiac function by using intraoperative transesophageal echocardiography.
authors.affiliation: Department of Anesthesiology, Kobe City Medical Center General Hospital, Kobe 650-0046.
authors.forename: Hideya
authors.initials: H
authors.lastname: Seo
authors.forename: Ikuko
authors.initials: I
authors.lastname: Miyawaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Higashibeppu
authors.forename: Shun
authors.initials: S
authors.lastname: Okazaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mima
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Seo
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamazaki
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D002395:Catecholamines / Q000008:administration & dosage; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines