ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
William L. Holman
David C. McGiffin
James K. Kirklin
Albert D. Pacifico
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Holman, W. L.
Right arrow Articles by Pacifico, A. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Holman, W. L.
Right arrow Articles by Pacifico, A. D.

Ann Thorac Surg 2000;70:1970-1973
© 2000 The Society of Thoracic Surgeons

Original article: cardiovascular

Right thoracotomy for mitral reoperation: analysis of technique and outcome

William L. Holman, MDa, Steven P. Goldberg, MDa, Lesley J. Earlya, David C. McGiffin, MDa, James K. Kirklin, MDa, Derrick H. Cho, BSa, Albert D. Pacifico, MDa

a Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA

Accepted for publication June 21, 2000.

Address reprint requests to Dr Holman, Department of Surgery, University of Alabama at Birmingham, 719 ZRB, 703 S 19th St, Birmingham, AL 35294-0007
e-mail: wholman{at}its.uab.edu

Background. This report describes technical details of the right thoracotomy approach for mitral surgery, and analyzes our experience with this procedure for patients with a prior sternotomy. Three methods for myocardial management (hypothermic cardioplegic arrest, beating heart, and fibrillating heart) are compared.

Methods. Records were abstracted of patients who had a right thoracotomy between January 1, 1992 and July 1, 1999 for mitral surgery after at least one prior sternotomy. Demographic, operative, and outcome data were collected for analysis. Telephone follow-up was used to measure postoperative New York Heart Association functional status.

Results. Eighty-four patients (mean age 60 ± 15 years) had reoperative mitral surgery via a right thoracotomy. Myocardial management included ventricular fibrillation in 10 patients, operation on the beating heart in 58 patients, and hypothermic blood cardioplegia arrest in 16 patients. The mean time in the operating room was 185 ± 73 minutes, and the mean duration of cardiopulmonary bypass was 63 ± 56 minutes. There were no perioperative strokes and the prevalence of death for patients who received cardioplegic arrest was significantly higher than the prevalence of death for patients who had mitral surgery with perfused fibrillating or beating heart techniques (p = 0.007; Fisher’s exact test comparing risk-unadjusted mortality).

Conclusions. Right thoracotomy provides efficient exposure for reoperative mitral surgery. Mitral valve procedures on the fibrillating or beating heart are feasible in most patients and are at least as safe as surgery using cardioplegic arrest.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
Y. Suzuki, F. D. Pagani, and S. F. Bolling
Left thoracotomy for multiple-time redo mitral valve surgery using on-pump beating heart technique.
Ann. Thorac. Surg., August 1, 2008; 86(2): 466 - 471.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. F. Loulmet, N. C. Patel, J. M. Jennings, and V. A. Subramanian
Less invasive intracardiac surgery performed without aortic clamping.
Ann. Thorac. Surg., May 1, 2008; 85(5): 1551 - 1555.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
J. P. Greelish, R. M. Ahmad, J. M. Balaguer, M. R. Petracek, and J. G. Byrne
Reoperative Valve Surgery
Card. Surg. Adult, January 1, 2008; 3(2008): 1159 - 1174.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
L. G. Svensson, A. M. Gillinov, E. H. Blackstone, P. L. Houghtaling, K.-H. Kim, G. B. Pettersson, N. G. Smedira, M. K. Banbury, and B. W. Lytle
Does right thoracotomy increase the risk of mitral valve reoperation?
J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 677 - 682.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Mohammadi, P. Voisine, P. Mathieu, and F. Dagenais
Use of the endoclamp device in a patient with a native mitral valve endocarditis and a previous arch replacement with a modified Griepp technique
J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1188 - 1190.
[Full Text] [PDF]

Home page
 Card Surg AdultHome page
J. G. Byrne, B. J. Phillips, and L. H. Cohn
Reoperative Valve Surgery
Card. Surg. Adult, January 1, 2003; 2(2003): 1047 - 1056.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
W. R. Burfeind, D. D. Glower, R.D. Davis, K. P. Landolfo, J. E. Lowe, and W. G. Wolfe
Mitral surgery after prior cardiac operation:port-access versus sternotomy or thoracotomy
Ann. Thorac. Surg., October 1, 2002; 74(4): S1323 - 1325.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. N. Pierson III, R. Howser, T. Donaldson, W. H. Merrill, R. J. Dignan, D. C. Drinkwater Jr, K. G. Christian, J. Butler, D. Chomsky, J. R. Wilson, et al.
Left ventricular assist device implantation via left thoracotomy: alternative to repeat sternotomy
Ann. Thorac. Surg., March 1, 2002; 73(3): 997 - 999.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The Society of Thoracic Surgeons.