[HSF] Rt thoracotomy MVR

[Ani Anyanwu]

Dr Zhou
 
Thanks for posting picture - excellent exposure and repair - always good to see a real life image rather than hear the theory. I intend to do more of these myself. 
 
Reassuring to me to note though that this incision is probably up to 10cm or more in length (jugding from the length of the ring and cardiotomy sucker and that the exposure takes a square shape which will become linear, and longer, on retractor removal) and that ribs have been spread substantially. In prior posts it has been said that this surgery is easily done through a 5cm incision.  I had my doubts as to how I personally could effect a repair through such an incision under direct vision. 
 
Having seen a few of these 'mini-mitrals' come for reoperations, I often note a perception gap between what the surgeon feels is the length of his incision and the reality when you measure it (most surgeons grossly underestimate) - there are I suspect very few mitrals that are truly done via 5cm incisions without rib-spreading, as some may claim, unless robotic or videoscopic approaches are used.
 
Ani
 
 



> From: zzhoumd at pol.net> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Rt thoracotomy MVR> Date: Wed, 9 Apr 2008 16:21:57 -0400> CC: > > We had a good discussion about right thoracotomy approach. I attached a picture of right thoracotomy mitral valve repair. This is the case I did recently with ablation and closure of appendage.> > Z Zhou
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