RIGHT THORACOTOMY AS AN ALTERNATIVE FOR REDO MITRAL-VALVE REPLACEMENTAND CONCOMITANT REPAIR OF THE TRICUSPID-VALVE

Background. We report the results of a right thoracotomy for reoperati on on the mitral valve plus concomitant procedures, Access to the aort a or to repair of other lesions by this approach is controversial, Exp erimental design and setting. Retrospective study, Institutional pract ice (University of Tsukuba Hospital, Tsukuba, Japan). Methods. Until 1 995, 9 patients underwent right thoracotomy for mitral valve reoperati on. The indication for this approach was no retrosternal space with th e pericardium left open. Seven patients had deteriorated bioprosthesis , 1 periprosthetic valve leakage, and 1 re-stenosis. Four were associa ted with moderate tricuspid regurgitation, Operations were performed u nder fibrillation. Cardioplegia was used in 1, Results, Through thorac otomy, 4 underwent mitral valve re-replacement, and 4 mitral valve re- replacement plus tricuspid annuloplasty, One was abandoned because of severe pleural adhesion, No neurological injury, or perioperative myoc ardial infarction occurred. Conclusions, The right thoracotomy was an effective alternative to repeat sternotomy for redo mitral valve opera tion. Also, concomitant repair of the tricuspid valve could be safely done by this approach.