Korean J Thorac Cardiovasc Surg 2018; 51(4): 283-285  https://doi.org/10.5090/kjtcs.2018.51.4.283
Minimally Invasive Redo Mitral Valve Replacement under Fibrillatory Arrest in a Patient with a Calcified Aorta and Patent Previous Bypass Grafts
Seung Hyun Kim, M.D., Hak Ju Kim, M.D., Ho Young Hwang, M.D., Ph.D.
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine
Corresponding author: Ho Young Hwang, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
(Tel) 82-2-2072-3020 (Fax) 82-2-764-3664 (E-mail) scalpel@hanmail.net
Received: March 28, 2018; Revised: April 29, 2018; Accepted: May 2, 2018.; Published online: August 5, 2018.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

cc This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annulo-plasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement.
Keywords: Minimally invasive surgical procedures, Mitral valve, replacement, Aortic cross-clamping, Reoperation, Stroke


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