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Evaluation of AorticValve Replacement viathe Right ParasternalApproach without RibRemoval Akimasa MorisakiKoji HattoriYasuyuki Kato2014 год

Evaluation of Aortic Valve Replacement via the Right Parasternal Approach without Rib Removal
статья из журнала

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Аннотация: Although right parasternal approach (RPA) decreases the incidence of mediastinal infection, this approach is associated with lung hernia and flail chest. Our RPA employs thoracotomy with bending rib cartilages and wound closure performed by repositioning the ribs with underlying sheet reinforcement.We evaluated 16 patients who underwent aortic valve replacement via the RPA from January 2010 to August 2013. We compared outcomes of 15 male patients had the RPA with 30 male patients had full median sternotomy.One patient with a history of radical breast cancer treatment underwent RPA with concomitant right coronary artery bypass grafting. No hospital deaths occurred. Four patients developed hospital-associated morbidity (re-exploration for bleeding, prolonged ventilation, cardiac tamponade, and perioperative myocardial infarction). There were no conversions to full median sternotomy, mediastinal infections, and lung hernias. Preoperative computed tomography showed that the distance from the right sternal border to the aortic root was significantly associated with operation times. With RPA, there was no significant difference in outcomes, despite significantly longer operation times compared with full median sternotomy.Our RPA provides satisfactory outcomes without lung hernia, especially in patients unsuitable for sternotomy. Preoperative computed tomography is useful for identifying appropriate candidates for the RPA.
Год издания: 2014
Авторы: Akimasa Morisaki, Koji Hattori, Yasuyuki Kato, Manabu Motoki, Yosuke Takahashi, Shinsuke Nishimura, Toshihiko Shibata
Издательство: Editorial Committee of Annals of Thoracic and Cardiovascular Surgery
Источник: Annals of Thoracic and Cardiovascular Surgery
Ключевые слова: Cardiac Valve Diseases and Treatments, Cardiac and Coronary Surgery Techniques, Aortic Disease and Treatment Approaches
Другие ссылки: Annals of Thoracic and Cardiovascular Surgery (PDF)
Annals of Thoracic and Cardiovascular Surgery (HTML)
Europe PMC (PubMed Central) (PDF)
Europe PMC (PubMed Central) (HTML)
PubMed Central (HTML)
PubMed (HTML)