An approach to mitral valve surgery by a T-shaped mini-sternotomy with functioning bilateral internal thoracic artery grafts |
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Authors: | Yosuke Takahashi Yasushi Tsutsumi Osamu Monta Yasuyuki Kato Keitaro Kohshi Tomohiko Sakamoto Hirokazu Ohashi |
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Institution: | (1) Department of Cardiothoracic & Vascular Surgery, Fortis Hospital, Noida, U.P., India, B-22, Sector-62, 201301 |
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Abstract: | We herein report successful surgical treatment of mitral valve regurgitation in a 49-year-old man. He was admitted to our
hospital due to acute aggravation of dyspnea on effort. He had a surgical history of coronary artery bypass grafting with
bilateral internal thoracic artery grafts. A transthoracic echocardiogram showed severely decreased cardiac function and severe
mitral regurgitation due to anterolateral mitral valve leaflet prolapse. Computed tomography showed the right internal thoracic
artery running over the front of the aorta to the left circumflex artery. To avoid injury to the functioning grafts during
median sternotomy, we chose to perform an inferior T-shaped mini-sternotomy. The surgical field was sufficient to perform
mitral valve replacement with a mechanical prosthetic valve under fibrillatory arrest. The grafts were neither dissected nor
clamped, and access to the aorta and mitral valve was excellent. |
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