A Case of Redo Aortic Valve Replacement by Right Minithoracotomy Approach with Port Access for Aortic Valve Stenosis after Coronary Artery Bypass Grafting

(Department of Cardivascular Surgery, Iwakuni Clinical Center, Iwakuni, Japan, and Department of Cardiovascular Surgery, Kameda Medical Center*, Kamogawa, Japan)

Takanori Tokuda Takashi Murakami* Yuki Yamada
Takashi Yamamoto Satoru Oya
We report a case of redo aortic valve replacement by right minithoracotomy approach for aortic stenosis after coronary artery bypass grafting(CABG). An 81-year-old man was followed-up once a year for 9 years after CABG. He complained of increasing respiratory distress, showed narrowing of the aortic valve area, elevation of the aortic valve pressure gradient, and tricuspid valve regurgitation by echocardiography. He was admitted for surgery. We considered minimally invasive operation would be better for him and performed aortic valve replacement(Carpentier-Edwards Perimaunt valve 19mm)by a right minithoracotomy approach because graft injury could occur by median sternotomy after CABG, and he had the risks of advanced age, low activities of daily living, and mild dementia. His postoperative course was uneventful. On echocardiography performed at postoperative days 9, the ejection fraction recovered to 75% from 53% before surgery and the mean aortic valve pressure gradient was 8mmHg. He was discharged on postoperative day 12. Right minithoracotomy approach with port access is a good option for redo operation for aortic valve stenosis after CABG.
  Jpn. J. Cardiovasc. Surg. 41:320-322(2012)

Keywords:aortic valve replacement, right thoracotomy, post CABG, aortic valvular stenosis, minimally invasive surgery