Mitral valve repair for infective endocarditis after esophageal reconstruction: a case report
Tóm tắt
In patients with retrosternal neo-esophageal conduit after right thoracotomy, the approach to cardiac surgery could be challenging. Particularly, in patients with infective endocarditis, there is a risk of injury to the conduit through standard median sternotomy. Moreover, right lung adhesions could be predicted. Herein, we present a case of successful mitral valve repair in a patient with infective endocarditis through a redo right thoracotomy after esophageal reconstruction. A 66-year-old male patient was diagnosed with infective endocarditis and a large anterior mitral leaflet vegetation after a previous esophageal reconstruction via right thoracotomy for esophageal cancer. Due to the retrosternal esophageal reconstruction, we performed a mitral valve repair through a redo right thoracotomy. After resecting the vegetation, the defect was closed with a fresh autologous pericardial patch. Mitral valve annuloplasty was performed. Postoperatively, antibiotics controlled the infection. The patient was discharged on postoperative day 30. Successful mitral valve repair was performed for infective endocarditis through a redo right thoracotomy after esophageal reconstruction.
Tài liệu tham khảo
Weksler B, Sullivan JL. Survival after esophagectomy: a propensity-matched study of different surgical approaches. Ann Thorac Surg. 2017;104:1138–46.
Watanabe M, Toh Y, Ishihara R, Kono K, Matsubara H, Miyazaki T, et al. Comprehensive registry of esophageal cancer in Japan, 2015. Esophagus. 2023;20:1–28.
Inra ML, Daly RC, Nichols FC 3rd, Pochettino A, Schaff HV, Crestanello JA. Cardiac surgery after extraanatomic esophageal reconstruction: a single institution’s experience. Ann Thorac Surg. 2020;110:2013–9.
Wakasa S, Ooka T, Kubota S, Shiiya N, Murashita T, Matsui Y. Aortic valve replacement through left thoracotomy after esophageal operation. Ann Thorac Surg. 2008;86:1668–70.
Numaguchi R, Shiiku C. Combined mitral valve replacement and coronary artery bypass grafting through a left thoracotomy after retrosternal oesophageal reconstruction. Interact Cardiovasc Thorac Surg. 2022;35: ivac161.
Prestipino F, D’Ascoli R, Nagy Á, Paternoster G, Manzan E, Luzi G. Mini-thoracotomy in redo mitral valve surgery: safety and efficacy of a standardized procedure. J Thorac Dis. 2021;13:5363–72.
Sakaguchi T. Minimally invasive mitral valve surgery through a right mini-thoracotomy. Gen Thorac Cardiovasc Surg. 2016;64:699–706.
Okada Y, Nakai T, Muro T, Ito H, Shomura Y. Mitral valve repair for infective endocarditis: Kobe experience. Asian Cardiovasc Thorac Ann. 2020;28:384–9.