Ikemoto Koki, Takahashi Akiyuki, Ohkawa Kazunari, Oka Katsuhiko, Sakaguchi Taichi
Department of Cardiovascular Surgery, Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, Japan.
Department of Cardiovascular Surgery, Hyogo College of Medicine, Hyogo, Japan.
Ann Thorac Surg Short Rep. 2025 Feb 17;3(3):633-636. doi: 10.1016/j.atssr.2025.01.014. eCollection 2025 Sep.
The median sternotomy approach presents significant challenges in patients who have a neo-esophageal conduit through the retrosternal route. We report a case of successful mitral valve repair through a right mini-thoracotomy to avoid injury to the neo-esophageal conduit in a 74-year-old man with a history of retrosternal reconstruction after esophagectomy. Intraoperative direct echocardiography was used to assess the severity of mitral valve regurgitation. Hence, the right mini-thoracotomy approach might be suitable in patients with a history of neo-esophageal reconstruction. In addition, direct intraoperative echocardiography might be useful when transesophageal echocardiography cannot be performed.
对于经胸骨后途径建立新食管通道的患者，正中胸骨切开术入路存在重大挑战。我们报告了一例通过右胸小切口成功修复二尖瓣的病例，该患者为一名74岁男性，有食管切除术后胸骨后重建史，采用此入路以避免损伤新食管通道。术中使用直接超声心动图评估二尖瓣反流的严重程度。因此，右胸小切口入路可能适用于有新食管重建史的患者。此外，当无法进行经食管超声心动图检查时，术中直接超声心动图可能会有帮助。
