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The Annals of Thoracic Surgery, Vol 48, 69-71, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Right thoracotomy, femorofemoral bypass, and deep hypothermia for re- replacement of the mitral valve

LH Cohn, PS Peigh, J Sell and VJ DiSesa
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115.

Ten patients underwent mitral valve re-replacement for the third to sixth time through a right thoracotomy using one-lung anesthesia, femorofemoral bypass, profound systemic hypothermia, and low-flow perfusion without aortic cross-clamping or cardioplegia. The indications for this approach were previous mediastinitis, severe right ventricular hypertension with multiple previous sternotomies, intact coronary artery bypass graft, or previous aortic valve replacement. There was 1 operative death, which was due to end-stage pulmonary hypertension and intractable right heart failure. Blood loss was minimal, and there was no major postoperative morbidity in the 9 surviving patients except for supraventricular arrhythmias.


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