title: A Cranial-Sided Approach for Repeated Mitral Periprosthetic Leak After Right Pneumonectomy.
abstract: A 72-year-old man presented with worsening dyspnea on effort. He underwent right pneumonectomy 40 years ago, then mitral valve replacement through a right thoracotomy 8 years ago with repeat surgery to repair a periprosthetic valve leak; the mediastinum was displaced to the right, and the heart was rotated counterclockwise. Transthoracic echocardiography showed periprosthetic valve leak recurrence near the left atrial appendage. We repaired the periprosthetic valve leak through a median sternotomy. Transecting the main pulmonary artery allowed us to widely open the cranial-sided left atrium. We obtained good exposure of the mitral valve, and repaired the periprosthetic valve leak using pledgeted sutures and a pericardial patch.
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan. Electronic address: ysk@msic.med.osaka-cu.ac.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shibata
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Motoki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Akimasa
authors.initials: A
authors.lastname: Morisaki
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Hattori
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000601:surgery; D001705:Bioprosthesis; D002315:Cardiopulmonary Bypass / Q000379:methods; D004452:Echocardiography; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010496:Pericardium / Q000601:surgery / Q000637:transplantation; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D056346:Sternotomy / Q000379:methods; D013524:Surgical Flaps / Q000637:transplantation*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000601:surgery