Left Anterior Mini-Incision for Pulmonary Valve Replacement Following Tetralogy of Fallot Repair. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Nellis, Joseph R.; Vekstein, Andrew M.; Meza, James M.; Andersen, Nicholas D.; Haney, John C.; Turek, Joseph W.
• Is Part Of: Innovations. Volume 15:Issue 2(2020)
• Page Start: 106
• Page End: 110
• Publication Date: 2020-03
• Subjects: pulmonary valve replacement -- Tetralogy of Fallot -- congenital heart defect -- minimally invasive congenital cardiac surgery; Cardiovascular system -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Thorax -- Chirurgie -- Méthodologie -- Périodiques; Vaisseaux sanguins -- Chirurgie -- Méthodologie -- Périodiques; Blood-vessels -- Surgery; Chest -- Surgery; Periodicals; 617.41
• DOI: 10.1177/1556984520911025
• Languages: English
• ISSNs: 1556-9845

Abstract

Pulmonary insufficiency is a known complication following Tetralogy of Fallot repair. With over 90% of patients now surviving to adulthood, surgeons are once again faced with the question of when, and more importantly, how to reintervene. We developed a novel approach to pulmonary valve replacement in this population through a 5-cm left anterior mini-incision. The incision is optimized for exposing and operating on the right ventricular outflow tract and the main pulmonary artery in patients with a history of median sternotomy. Early outcomes are reassuring, and we believe our approach is a safe and reliable alternative to median sternotomy within this patient population, with the ability to quickly convert intraoperatively when needed.