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. 2023 Dec;71(8):614-619.
doi: 10.1055/s-0041-1731284. Epub 2022 Feb 8.

Single or Combined Valve Surgery and Concomitant Right Coronary Artery Bypass through Right Anterior Minithoracotomy Approach

Ali Ihsan Hasde  1 , Mehmet Cahit Sarıcaoğlu  1 , Mustafa Kılıçkap  2 , Mustafa Serkan Durdu  1
Affiliations

Single or Combined Valve Surgery and Concomitant Right Coronary Artery Bypass through Right Anterior Minithoracotomy Approach

Ali Ihsan Hasde et al. Thorac Cardiovasc Surg. 2023 Dec.

Abstract

Background: Patients with combined valve and coronary artery disease are commonly performed by standard median sternotomy approach for coronary artery bypass grafting (CABG) and valve surgery. The purpose of this study is to describe our experience and show feasibility and safety of minimally invasive approach to single or combined valve pathology with single-vessel right coronary artery (RCA) disease, even if it is suitable to percutaneous coronary intervention.

Methods: This retrospective study comprised 28 consecutive patients who underwent single or combined valve surgery concomitant right CABG through right anterior minithoracotomy between February 2018 and December 2020. Preoperative evaluation, intraoperative, and postoperative outcomes were reviewed and analyzed.

Results: There were 12 men and 16 women. The mean age was 71.46 ± 6.82 years. Ten patients were in New York Heart Association class III or IV. The mean cardiopulmonary bypass and aortic cross-clamping times were 117.6 ± 21.3 and 98.1 ± 22.6 minutes, respectively. The mean time to extubation was 9.7 ± 5.6 hours, the mean intensive care unit stay was 37.4 ± 14.6 hours, and the mean hospital stay was 6.9 ± 3.2 days. There was one patient who underwent reoperation for bleeding. There were no instances of postoperative stroke, myocardial infarction, renal failure, or wound infection. The mean follow-up was 19 ± 2.4 months.

Conclusion: Presence of RCA lesion is not a contraindication for minimally invasive approach in cases who underwent single or combined valve surgery. Combined valve surgery and right CABG via right anterior minithoracotomy are a safe and feasible option to standard median sternotomy surgery, even if RCA lesions seem suitable for stenting.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
( A ) Coronary angiography diagram of posterior descending artery (PDA) lesion. ( B ) Exposure of PDA lesion. ( C ) Anastomosis of PDA lesion. ( D ) Anastomosis of proximal right coronary artery lesion.
See this image and copyright information in PMC

References

    1. Murzi M, Cerillo A G, Bevilacqua S, Gilmanov D, Farneti P, Glauber M. Traversing the learning curve in minimally invasive heart valve surgery: a cumulative analysis of an individual surgeon's experience with a right minithoracotomy approach for aortic valve replacement. Eur J Cardiothorac Surg. 2012;41(06):1242–1246. - PubMed
    1. Raja S G, Navaratnarajah M. Impact of minimal access valve surgery on clinical outcomes: current best available evidence. J Card Surg. 2009;24(01):73–79. - PubMed
    1. Cohn L H, Adams D H, Couper G Set al.Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair Ann Surg 199722604421–426., discussion 427–428 - PMC - PubMed
    1. Navia J L, Cosgrove D M., III Minimally invasive mitral valve operations. Ann Thorac Surg. 1996;62(05):1542–1544. - PubMed
    1. Schmitto J D, Mokashi S A, Cohn L H. Minimally-invasive valve surgery. J Am Coll Cardiol. 2010;56(06):455–462. - PubMed