Although sternotomy represents the main surgical access for most cardiac interventions, there are some cases in which alternative surgical approaches may be safer. A re-sternotomy may determine, in patients affected by posterior or very lateral pericardial effusion or mass and in redo-surgery procedures, an increased risk of injury to cardiac structures or previously placed bypass grafts. Moreo...

BACKGROUND Although minimally invasive coronary artery bypass grafting (MICS-CABG) has been shown to result in excellent clinical outcomes overall adoption rates still remain low. Traditional strategies for minimally invasive multivessel revascularization - usually performed through single-thoracotomy - have to deal with restricted grafting possibilities and possible increased susceptibility of...

OBJECTIVE To examine the short- and long-term results of right extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma (MM) via median sternotomy or thoracotomy. METHODS We analysed the results of EPP in consecutive patients with early stage MM undergoing a radical surgery protocol for MM over a 7-year period. Initially thoracotomy, but later median sternotomy, was the incision of...

BACKGROUND Progression of disease and bypass graft attrition results in a population of patients who require repeated coronary interventions. Frequently, these patients have patent internal mammary artery grafts and require isolated intervention to the circumflex distribution. As an alternative to high-risk repeated sternotomy and conventional bypass surgery or catheter-based intervention, the ...

OBJECTIVE : This meta-analysis sought to determine whether minimally invasive mitral valve surgery (mini-MVS) improves clinical outcomes and resource utilization compared with conventional open mitral valve surgery (conv-MVS) in patients undergoing mitral valve repair or replacement. METHODS : A comprehensive search of MEDLINE, Cochrane Library, EMBASE, CTSnet, and databases of abstracts was ...

We describe a case of a 78-year-old female with chronic obstructive pulmonary disease (COPD), diabetes, obesity, impaired renal function and severe aortic valve stenosis with associated insufficiency (Video 1). The patient was symptomatic for dyspnea (class NYHA III). Her medical history included breast cancer treated with mastectomy two years prior. The logistic Euroscore was 19.17%. After ech...

The performance of cardiac surgical procedures via median sternotomy in a patient with a tracheostomy can result in difficult problems, such as mediastinitis, stoma necrosis or inadequate operative exposure. We present a case of successful treatment for aortic valve regurgitation in a patient with a tracheostomy using a T-shaped sternotomy instead of a usual median sternotomy. This approach per...

Median sternotomy is the most commonly used incision in cardiothoracic procedures. Development of breast abscess after sternotomy is a very rare situation. We present a case of sternal wound infection with recurrent bilateral breast abscess after sternotomy. Our case is the first and only case in the literature due to the presence of sternal wound infection with recurrent bilateral breast absce...