| Mitral Reoperation via
Partial Sternotomy |
(Department of Cardiovascular Surgery Koshigaya Hospital,
Dokkyo University School of Medicine, Koshigaya, Japan)
| Nobuaki Kaki |
Takao Imazeki |
Yoshihito Irie |
| Hiroshi Kiyama |
Noriyuki Murai |
Hirotugu Yoshida |
| Shigeyoshi Gon |
Souichi Shioguchi |
Masahito Saito |
| Shuichi Okada |
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A conventional reoperation via full sternotomy approach
is associated with a higher risk of heart injury compared with first time operations.
We employ a minimally invasive cardiac surgery (MICS) for valve reoperations in
order to minimize dissection of sternal adhesions. We evaluated MICS for mitral
reoperation in this report. We retrospectively analyzed 20 patients (group P) who
underwent mitral reoperation via partial lower hemisternotomy (PLH) from July 1997
through March 2002, and 13 patients (group F) who underwent mitral reoperation via
full sternotomy from April 1990 through June 1997. All patients received mitral
valve replacement in both groups. Concomitant Maze procedures were significantly
more frequent in group P (group P: n＝8, group F: n＝1). Aortic cross clamp
times were significantly longer in group P (group P: 110±5min, group F: 87±11min).
The blood loss during operations was significantly less in group P (group P: 666±100ml, group F: 2,405±947ml).
Postoperative ventilation time and the length of intensive care unit stay were significantly shorter in group P.
In group P and F the occurrence of a heart injury associated with sternotomy was 0/20 (0%)，2/13(15%) respectively.
Hospital mortality was 0/20 (0%)，2/13 (15%) respectively. There were neither any hospital deaths nor any
postoperative major complications in group P. We conclude that PLH for mitral reoperations could be performed safely and
is an alternative approach for mitral reoperations.
Jpn. J. Cardiovasc. Surg. 34: 163-166 (2005) |
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