Right-parasternal approach for aortic valve replacement and ascending aortic repair after ante-thoracic route gastric tube reconstruction.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiac Surgery Pub Date : 2022-12-01 DOI:10.1111/jocs.17052
Takamichi Nishida, Takanori Kono, Kazuyoshi Takagi, Eiki Tayama
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Abstract

Due to the limitations of surgical incisions and approaches brought on by the presence of gastric tube (GT), open heart surgery following ante-thoracic route GT reconstruction remains challenging. A-73-year-old man, who had a history of esophageal resection and ante-thoracic route GT reconstruction required aortic valve replacement (AVR) concomitant with ascending aortic repair (AAR) for aortic stenosis and dilated ascending aorta. We performed open heart surgery via a right-parasternal approach to avoid injury to the GT and nutrient arteries. This approach provided a good operative field, similar to median sternotomy. To our knowledge, this is the first case of AVR concomitant with AAR after ante-thoracic route GT reconstruction via a right-parasternal approach. We consider that the right-parasternal approach is reasonable for patients with ante-thoracic route GT reconstruction.

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右胸骨旁入路在胸前胃管重建术后主动脉瓣置换术和升主动脉修复中的应用。
由于胃管(GT)存在所带来的手术切口和入路的限制,经胸径胃管重建后的心内直视手术仍然具有挑战性。一名73岁男性,有食管切除术和胸前路GT重建史,因主动脉狭窄和升主动脉扩张需要主动脉瓣置换术(AVR)合并升主动脉修复术(AAR)。我们通过右胸骨旁入路进行心内直视手术,以避免损伤GT动脉和营养动脉。该入路提供了良好的手术野,类似于胸骨正中切开术。据我们所知,这是第一例经右胸骨旁入路经胸前路GT重建后AVR合并AAR的病例。我们认为右胸骨旁入路对胸前路GT重建患者是合理的。
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来源期刊
CiteScore
2.90
自引率
12.50%
发文量
976
审稿时长
3-8 weeks
期刊介绍: Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.
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