title: Multiple valve surgery for a patient with presternal oesophageal reconstruction.
abstract: A 73-year old woman presented with progressive exertional dyspnoea. Echocardiography revealed severe regurgitation of the aortic, mitral and tricuspid valves, indicating the need for multiple valve surgery. The patient had a past history of oesophageal cancer that had been treated with chemoradiotherapy followed by oesophagectomy with presternal reconstruction using a gastric tube and a pedicled jejunum covered by the rectus abdominal muscle flap. She underwent aortic and mitral valve replacement with prostheses and tricuspid ring annuloplasty through a lower partial median sternotomy to avoid injury to the cervical oesophagus and a pedicled jejunum placed on the sternal manubrium.
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hiroshima, Japan cardiovascsurgeon@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hamamoto
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Taira
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ozawa
mesh_terms: D000368:Aged; D058385:Cardiac Valve Annuloplasty / Q000379:methods; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000601:surgery* / Q000628:therapy; D016629:Esophagectomy / Q000379:methods; D004944:Esophagoplasty / Q000379:methods; D005260:Female; D006349:Heart Valve Diseases / Q000209:etiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D056346:Sternotomy / Q000379:methods
keywords: Lower partial sternotomy; Multiple valve surgery; Oesophageal cancer; Presternal reconstruction