Reoperations for mitral valve disease: Surgical approaches and techniques

Approximately 10% of all adult cardiac operations involve redo thoracotomy, and clinically significant hemorrhage occurs in up to 8% of patients with a resultant increase in operative morbidity and mortality (Ann Thorac Surg 68: 2215-9, 1999). Indeed, in some reports, prior cardiac surgery increases the operative risk of mitral valve (MV) surgery almost twofold (J Am Coll Cardiol 37: 885-92, 2001; J Thorac Cardiovasc Surg 131: 547-57, 2006). Reoperation for MV disease is necessary for a wide variety of problems, such as failure of a previously placed prosthesis, development of a paravalvular leak, endocarditis, or newly diagnosed valve disease in a patient with prior aortic valve replacement or coronary artery bypass.