Entrar/Registro  
HOME SPANISH
 
Cirujano General
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirujano General >Year 2009, Issue 4


Miramontes MJC, Careaga RG
Right thoracotomy in mitral valve reoperation
Cir Gen 2009; 31 (4)

Language: Español
References: 8
Page: 236-238
PDF: 4. Kb.


Full text




ABSTRACT

Objective: To present our experience and demonstrate that right thoracotomy in patients with previous sternotomy is and option that may decrease morbidity and mortality in cardiosurgical reinterventions. Place: Third-level attention hospital. Design: Study of cases and controls. Statistical analysis: Pearson’s chi-square test. Material and methods: It was reviewed the cases of reinterventions for mitral valve surgery performed during the period going from January 1st 1997 and December 31st 2000 on patients who had been subjected to right thoracotomy and they were compared with a similar group that had been operated using sternotomy. Surgical time, associated morbidity and mortality were compared. Results: Forty patients having similar demographic characteristic were operated. Ten of then were operated through right thoracotomy, while 30 patients were operated by means of median sternotomy. The survival was of 90% in those patients that were subjected to right thoracotomy and 70% for the patients of the sternotomy. The time of pulmonary derivation was of 94.8 minutes in the right thoracotomy, against 121.4 minutes when considering the sternotomy. The re-exploration by post-operative bleeding was of 0% for the thoracotomy group, and it was of 13% for the sternotomy (p ‹ 0.01). The blood transfusion was of 5.3 units for the thoracotomy group, while it was of 11.4 units for the sternotomy group (p ‹ 0.05). The 12-years follow-up period up to 12 years in the group of patients who had been subjected to thoracotomy did not show any difference that could be attributed to the surgical approach.Conclusion: Right thoracotomy is a safe surgical option and it also offers less morbidity and mortality in those cases where there is a background of one or two previous sternotomies.


Key words: Right thoracotomy, mitral surgery, sternotomy, cardiac surgery.


REFERENCIAS

  1. Thompson MJ, Behranwala A, Campanella C, Walker WS, Cameron FW. Immediate and long-term results of mitral prosthetic replacement using a right thoracotomy beating heart technique. Eur J Cardiothorac Surg 2003; 24: 47-51.

  2. Argüero R, Careaga G, Santaella M. Minitoracotomía paraesternal derecha para cirugía valvular mitral, aórtica y combinada. Rev Med IMSS (Mex) 1999; 37: 97-101.

  3. Esparza J, Careaga G, Argüero R. Miniesternotomía para el implante de prótesis aórtica. Cir Cir 2000; 68: 229-33.

  4. Byrne JG, Karavas AN, Adams DH, Aklog L, Aranski SF, Filsoufi F, et al. The preferred approach for mitral valve surgery after CABG: right thoracotomy, hypothermia and avoidance of LIMA-LAD graft. J Heart Valve Dis 2001; 10: 584-90.

  5. González G, Mejía D, Zapata J, Jaramillo JC, Durán M, Villegas A, Montoya JD. Toracotomía derecha para cierre de comunicación interauricular y cirugía valvular mitral. Rev Colomb Cardiol 1998; 6: 193-7.

  6. Braxton JH, Higgins RS, Schwann TA, Sanchez JA, Dewar ML, Kopf GS, et al. Reoperative mitral valve surgery via right thoracotomy: decreased blood loss and improved hemodynamics. J Heart Valve Dis 1996; 5: 169-73.

  7. Svensson LG, Gillinov MA, Blackstone EH, Houghtaling PL, Kim KH, Pettersson GB, et al. Does right thoracotomy increase the risk of mitral valve reoperation? J Thorac Cardiovasc Surg 2007; 134: 677-82.

  8. Wang D, Wang Q, Yang X, Wu Q, Li Q. Mitral valve replacement through a minimal right vertical infra-axillary thoracotomy versus standard median sternotomy. Ann Thorac Surg 2009; 87: 704-8.






>Journals >Cirujano General >Year 2009, Issue 4
 

· Journal Index 
· Links 






       
Copyright 2019