AI Summary & Key Takeaways
AI InsightWe emphasize that the right anterolateral thoracotomy is a safe and quick approach in reoperative tricuspid valve surgery and that either operation or postoperative period has an uneventful course.
📌 3 Key Takeaways
Abstract
We report a patient who had undergone a reoperative tricuspid valve replacement through right anterolateral thoracotomy after a previous mitral valve replacement. A 53 year-old woman whose mitral valve had been replaced 18 years previously was taken to reoperation for tricuspid valve replacement. She had grade 4 tricuspid insufficiency and stenosis (tricuspid valve area 1.44 cm2, mean transvalvular gradient 6.5 mmHg, peak transvalvular gradient 16 mmHg). Following right femoral artery cannulation right anterolateral thoracotomy was performed and thorax was entered through the 4th intercostal space. The pericardium was opened and adhesions were dissected. Total cardiopulmonary bypass was instituted with bicaval cannulation and tricuspid valve was replaced with a mechanical prosthesis while heart beating. We emphasize that the right anterolateral thoracotomy is a safe and quick approach in reoperative tricuspid valve surgery and that either operation or postoperative period has an uneventful course.
Özet
Mitral kapak replasmanı sonrası sağ torakotomi yolu ile triküspid kapak replasmanı uyguladığımız bir olguyu sunduk. Olgu sunumu: 18 yıl önce mitral kapak replasmanı uygulanmış 53 yaşında kadın hasta 4° triküspid kapak yetmezliği, triküspid kapak darlığı (tepe gradiyent 16 mmHg, ortalama gradiyent 6.5 mmHg, kapak alam 1.44 cm2) tanılarıyla cerrahiye alındı. Sağ femoral arter kanülasyonunu takiben sağ anterolateral torakotomi ile 4'ncü interkostal aralıktan toraksa girilerek perikard açıldı ve bikaval kanülasyon uygulandı. Total kardiopulmoner bypass ile çalışan kalpte mekanik protez kullanılarak triküspid kapak replasmanı yapıldı. Sonuç: Bu olguda reoperatif triküspid kapak replasmanının sağ anterolateral torakotomi yaklaşımı ile kolaylıkla ve güvenli olarak yapılabildiğini, aperatif sürecin resternotomiye göre daha olaysız ve hızlı olması yanı sıra postoperatif dönemin de cerrahi açıdan daha sorunsuz ve kolay tolere edilir olduğunu gördük.