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Repeated valve replacement surgery: technical tips and pitfalls

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Abstract

For successful repeated valve replacement surgery, it is essential issue that the preoperative evaluation includes an assessment of the previous operation record, computed tomography (CT: including 3D-CT), ultrasound cardiography, coronary artery angiography, and so on. Although it is especially needed for repeated valve replacement surgery, setting up of the external defibrillation pads is the most important preparation just prior to the surgery. In regard to the approach, re-sternotomy is frequently employed as a standard fashion because it allows us to re-entry any part of the heart. As alternative approaches, partial sternotomy, right thoracotomy for minimally invasive cardiac surgery approach have also been highlighted recently. Myocardial protection is another important consideration in repeated valve replacement surgery, especially in post-coronary artery bypass grafting cases with a patent internal thoracic artery. In repeated valve replacement surgery, special and unique techniques are required both for taking the affected prosthetic valve out and for implanting a new valve, which is dependent on the types of the previous prosthetic valve and the condition of the affected prosthetic valve. Therefore, for performing repeated valve replacement surgeries, surgeons should be highly skilled in these special techniques.

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References

  1. Furukawa H, Tanemoto K. Redo valve surgery -Current Status and Future Perspectives-. Ann Thorac Cardiovasc Surg. 2014;20:267–75.

    Article  PubMed  Google Scholar 

  2. Aviram G, Sharony R, Kramer A, et al. Modification of surgical plannning based on cardiac multidetector computed tomography in reoperative heart surgery. Ann Thorac Surg. 2005;79:589–95.

    Article  PubMed  Google Scholar 

  3. Kamdar AR, Meadows TA, Rosseli EE, et al. Multidetector computed tomography in planning or reoperative cardiothoracic surgery. Ann Thorac Surg. 2008;85:1239–45.

    Article  PubMed  Google Scholar 

  4. Anwar AM, Nosir TFM, Alasnag M, et al. Real time three-dimensional transesophageal echocardiography: a novel approach for the assessment of prosthetic heart valves. Echocardiography. 2014;31:188–96.

    Article  PubMed  Google Scholar 

  5. Tabata M, et al. Reoperative minimal access aortic valve surgery: minimal mediastinal dissection and minimal injury risk. J Thorac Cardiovasc Surg. 2008;136(6):1564–8.

    Article  PubMed  Google Scholar 

  6. Mikus E, Calvi S, Tripodi A, et al. Upper ‘J’ ministernotomy versus full sternotomy: an easier approach for aortic valve reoperation. J Heart Valve Dis. 2013;22:295–300.

    PubMed  Google Scholar 

  7. Romano MA, et al. Beating heart surgery via right thoracotomy for reoperative mitral valve surgery: a safe and effective operative alternative. J Thorac Cardiovasc Surg. 2012;144:334–9.

    Article  PubMed  Google Scholar 

  8. Meyer SR, et al. Reoperative mitral valve surgery by the port access minithoracotomy approach is safe and effective. Ann Thorac Surg. 2009;87:1426–30.

    Article  PubMed  Google Scholar 

  9. Vallabhajosyula P, Wallen TJ, Solometo LP, et al. Minimally invasive mitral valve surgery utilizing Heart Port technology. J Card Surg. 2014;29:343.

    Article  PubMed  Google Scholar 

  10. Botta L, Cannata A, Fratto P, et al. The role of the minimally invasive beating heart technique in reoperative valve surgery. J Card Surg. 2012;27:24–8.

    Article  PubMed  Google Scholar 

  11. Botta L, Cannata A, Bruschi G, et al. Minimally invasive approach for redo mitral valve surgery. J Thorac Dis. 2013;5:S686–93.

    PubMed  PubMed Central  Google Scholar 

  12. Luciani N, et al. Harmonic scalpel reduces bleeding and postoperative complications in redo cardiac surgery. Ann Thorac Surg. 2005;80:934–8.

    Article  PubMed  Google Scholar 

  13. Gillinov AM, et al. Injury to a patent left internal thoracic artery graft at coronary reoperation. Ann Thorac Surg. 1999;67:382–6.

    Article  PubMed  CAS  Google Scholar 

  14. Byrne JG, et al. Aortic valve surgery after previous coronary artery bypass grafting with functioning internal mammary artery grafts. Ann Thorac Surg. 2002;73:779–84.

    Article  PubMed  Google Scholar 

  15. Smith RL, et al. Do you need to clamp a patent left internal thoracic artery - left anterior descending graft in reoperative cardiac surgery? Ann Thorac Surg. 2009;87:742–7.

    Article  PubMed  Google Scholar 

  16. Fujita T, et al. Systemic hyperkalemia and mild hypothermia for valve surgery in patients with patent internal mammary artery graft. Interact CardioVasc Thorac Surg. 2010;11:3–5.

    Article  PubMed  Google Scholar 

  17. Kaneko T, et al. The “no-dissection” technique is safe for reoperative aortic valve replacement with a patent left internal thoracic artery graft. J Thorac Cardiovasc Surg. 2012;144:1036–41.

    Article  PubMed  Google Scholar 

  18. Liakopoulos OJ, Allen BS, Buckberg GD, Hristov N, Tan Z, Villablanca JP, et al. Resuscitation after prolonged cardiac arrest: role of cardiopulmonary bypass and systemic hyperkalemia. Ann Thorac Surg. 2010;89(6):1972–9.

    Article  PubMed  Google Scholar 

  19. Hiraoka A, et al. Mitral valve reoperation under ventricular fibrillation through right mini-thoracotomy using three-dimensional videoscope. J Cardiothorac Surg. 2013;8:81–5.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Atoui R, Lash V, Mohammadi S, Cecere R. Intra-atrial implantation of a mitral valve prosthesis in a heavily calcified mitral annulus. Eur J Cardiothorac Surg. 2009;36:776–8.

    Article  PubMed  Google Scholar 

  21. Nataf P, Pavie A, Jault F, Bors V, Cabrol C, Gandjbakhch I. Intraatrial insertion of a mitral prosthesis in a destroyed or calcified mitral annulus. Ann Thorac Surg. 1994;58:163–7.

    Article  PubMed  CAS  Google Scholar 

  22. Nezic D, Knezevic A, Borovic S, Jovic M. Mitral valve replacement with posterior transposition of the anterior mitral leaflet which covers and buttresses partially decalcified posterior mitral annular bed. Eur J Cardiothorac Surg. 2012;41:1129–31.

    Article  PubMed  Google Scholar 

  23. Santarpino G, Pfeiffer S, Concistre G, et al. REDO aortic valve replacement: the sutureless approach. J Heart Valve Dis. 2013;22:615–20.

    PubMed  Google Scholar 

  24. Folliguet TA, Laborde F. Sutureless perceval aortic valve replacement in aortic homograft. Ann Thorac Surg. 2013;96:1866–8.

    Article  PubMed  Google Scholar 

  25. Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med. 2001;345:1318–30.

    Article  PubMed  CAS  Google Scholar 

  26. Prendergast BD, Tornos P. Surgery for infective endocarditis. Who and when? Circulation. 2010;121:1141–52.

    Article  PubMed  Google Scholar 

  27. Habib G, Tribouilloy C, Thuny F, et al. Prosthetic valve endocarditis: who needs surgery? A multicenter study of 104 cases. Heart. 2005;91:954–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  28. Ivert TSA, Dismukes WE, Cobbs CG, et al. Prosthetic valve endocarditis. Circulation. 1984;69:223–32.

    Article  PubMed  CAS  Google Scholar 

  29. David TE, Gavra G, Feidel CM, et al. Surgical treatment of active infective endocarditis: a continued challenge. J Thorac Cardiovasc Surg. 2007;133:144–9.

    Article  PubMed  Google Scholar 

  30. Kang DH, Kim YJ, Kim SH, et al. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med. 2012;366:2466–73.

    Article  PubMed  CAS  Google Scholar 

  31. Avierinos JF, Thuny F, Chalvignac V, et al. Surgical treatment of active aortic endocarditis: homografts are not the cornerstone of outcome. Ann Thorac Surg. 2007;84:1935–42.

    Article  PubMed  Google Scholar 

  32. Sabik JF, Lytle BW, Blackstone EH, et al. Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis. Ann Thorac Surg. 2002;74:650–9.

    Article  PubMed  Google Scholar 

  33. Darouiche RO, Fowler VG, Adal K, et al. Antimicrobial activity of prosthetic heart valve sewing cuffs coated with minocycline and rifampin. Antimicrob Agents Chemother. 2002;46:543–5.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  34. Furukawa H, Honda T, Tanemoto K, et al. Single interrupted suturing for redo mitral valve replacement provides ad appropriate prosthesis size and comparable early clinical outcomes. Cardiology. 2014;128:116.

    Google Scholar 

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan

    Kazuo Tanemoto & Hiroshi Furukawa

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  1. Kazuo Tanemoto
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  2. Hiroshi Furukawa
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Correspondence to Kazuo Tanemoto.

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This review was submitted at the invitation of the editorial committee.

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Tanemoto, K., Furukawa, H. Repeated valve replacement surgery: technical tips and pitfalls. Gen Thorac Cardiovasc Surg 62, 639–644 (2014). https://doi.org/10.1007/s11748-014-0473-z

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  • DOI: https://doi.org/10.1007/s11748-014-0473-z

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