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Redo mitral surgery after coronary artery bypass grafts under hyperkalemic hypothermia using thoracotomy and axillary artery cannulation in a patient with functional bilateral internal thoracic arteries and atheromatous aorta
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  • Ryo Suzuki,
  • Masafumi Akita,
  • Takaki Itohara,
  • Takuya Komatsu
Ryo Suzuki
Shinmatsudo Chuo Sogo Byoin

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Masafumi Akita
Shinmatsudo Chuo Sogo Byoin
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Takaki Itohara
Shinmatsudo Chuo Sogo Byoin
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Takuya Komatsu
Shinmatsudo Chuo Sogo Byoin
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We report a case of redo mitral and tricuspid valve repair via right thoracotomy under hypothermia and systemic potassium administration with axillary artery cannulation in a patient after coronary artery bypass grafting (CABG) with patent bilateral internal thoracic artery (ITA) grafts crossing over the sternum. Redo mitral valve surgery is challenging through re-sternotomy as previous CABG with patent ITA poses a risk of injury due to dense adhesion. Herein, dangerous dissection around the aorta and functional ITA grafts was avoided by performing the procedure under systemic hypothermia via thoracotomy. Furthermore, considering the presence of atheroma in the aorta, the axillary artery was used as a perfusion route to prevent stroke events. Performing axillary artery cannulation and right thoracotomy under hypothermic cardiac arrest with systemic hyperkalemia without clamping the patent bilateral ITAs and aorta allowed us to execute redo mitral valve surgery after CABG without major postoperative cardiac or cerebral complications.
03 Oct 2022Submitted to Journal of Cardiac Surgery
03 Oct 2022Assigned to Editor
03 Oct 2022Submission Checks Completed
07 Oct 2022Reviewer(s) Assigned
14 Oct 2022Review(s) Completed, Editorial Evaluation Pending
15 Oct 2022Editorial Decision: Revise Major