Right anterior mini thoracotomy for redo cardiac surgery: case series from North America and Europe

• DOI: 10.3389/fcvm.2024.1427930
• Publication Date: 2024-06-18T15:52:13Z
• Authors: Ali Fatehi Hassan...; Justyna Fercho; Mortaza Fatehi Ha...; Melissa King; Morgan Sosniuk; Dominique de Waard; Corey Adams; William D. T. Kent; Wojtek Karolak
• Keywords: Thoracotomy; Median sternotomy; Stroke; Renal replacement therapy

Background Right anterior mini thoracotomy (RAMT) for aortic valve replacement (AVR) is a minimally invasive procedure that avoids sternotomy. Herein, we report the outcomes of patients who underwent redo-cardiac via RAMT approach AVR. Methods This case series reports clinical 14 consecutive redo operations, done in Calgary (Canada) and Gdansk (Poland) between 2020 2023. Primary were 30-day mortality disabling stroke. Secondary included surgical times, hemodynamics, permanent pacemaker implantation (PPM), length ICU hospital stay, new post-operative atrial fibrillation (POAF), blood transfusion, incidence acute respiratory distress syndrome (ARDS), rate continuous renal therapy (CRRT) and/or dialysis, chest tube output first 12-hours after surgery. Results Nine male, mean age was 64.36 years. There no deaths, while one patient had stroke postoperatively. Mean cardiopulmonary bypass cross clamp-times 136 min 90 min, respectively. Three needed PPM, 3 transfusions, 2 developed onset POAF. Median lengths stays 12 days, paravalvular leak greater than trace average transvalvular gradient 12.23 mmHg. Conclusion The number requiring redo-AVR increasing. Redo-sternotomy may not be feasible many patients. study suggests safe alternative to redo-sternotomy require an