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.
Similar content being viewed by others
References
Karimi A, Ahmadi H, Davoodi S, Movahedi N, Marzban M, Abbasi K, et al. Factors affecting postoperative morbidity and mortality in isolated coronary artery bypass graft surgery. Surg Today 2008;38:890–898.
Byrne JG, Aranki SF, Adams DH, Rizzo RJ, Couper GS, Cohn LH. Mitral valve surgery after previous CABG with functioning IMA grafts. Ann Thorac Surg 1999;68:2243–2247.
Tosaka Y, Nakazawa S, Takahashi Y, Kanazawa H, Yamazaki Y. Inverted L-shape sternotomy as a minimally invasive approach: re-do cardiac surgery for papillary muscle rupture. Jpn J Thorac Cardiovasc Surg 2004;52:570–573.
Loulmet DF, Carpentier A, Cho PW, Berrebi A, d’Attellis N, Austin CB, et al. Less invasive techniques for mitral valve surgery. J Thorac Cardiovasc Surg 1998;115:772–779.
Farhat F, Aubert S, Rosamel P, Jegaden O. Inferior T hemisternotomy after previous bypass grafting with the in situ RITA in front of the aorta. Ann Thorac Surg 2005;80:1532–1533.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Takahashi, Y., Tsutsumi, Y., Monta, O. et al. An approach to mitral valve surgery by a T-shaped mini-sternotomy with functioning bilateral internal thoracic artery grafts. Surg Today 39, 922–924 (2009). https://doi.org/10.1007/s00595-009-3978-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-009-3978-9