{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:55:22Z","timestamp":1791392122668,"version":"4.3.3"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T00:00:00Z","timestamp":1628985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>A minimally invasive approach via a thoracotomy is an alternative in challenging redo cardiac procedures. Our goal was to present our early postoperative experience with minimally invasive cardiac surgery via a right minithoracotomy (minimally invasive) and resternotomy in patients undergoing a mitral valve procedure as a reoperation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>From 2017 until 2020, reoperation of the mitral valve was performed through a right-sided minithoracotomy in 27 patients and via a resternotomy in 26 patients. Patients with femoral vessels suitable for cannulation underwent a minimally invasive technique. Patients requiring concomitant procedures regarding the aortic valve were operated on via a resternotomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The mean age was 66\u2009\u00b1\u200912\u2009years in the minimally invasive group and 65\u2009\u00b1\u200912\u2009years in the whole cohort. The average Society of Thoracic Surgeons score was 11\u2009\u00b1\u200910% in the minimally invasive group and 13\u2009\u00b1\u20099% in all patients. The majority of the patients underwent reoperation because of severe mitral valve insufficiency (48% and 55%, respectively). The mean time to reoperation was 7\u2009\u00b1\u20099\u2009years (minimally invasive group). The 30-day mortality was 4% in the minimally invasive group and 11% in the whole cohort. The blood loss was 566\u2009\u00b1\u2009359\u2009ml in the minimally invasive group and 793\u2009\u00b1\u2009410\u2009ml totally. There were no postoperative neurological complications in the minimally invasive group and 1 (2%) in the whole cohort. Postoperative echocardiography revealed competent mitral valve\/prosthesis function in all patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A minimally invasive approach for a mitral valve reoperation in selected patients is a safe alternative to resternotomy with a low transfusion requirement. Both surgical techniques are associated with good postoperative outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivab228","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T19:10:52Z","timestamp":1628622652000},"page":"33-39","source":"Crossref","is-referenced-by-count":13,"title":["Right minithoracotomy and resternotomy approach in patients undergoing a redo mitral valve procedure"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6322-4605","authenticated-orcid":false,"given":"Nadejda","family":"Monsefi","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel","family":"Makkawi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Helios Heart Center Siegburg, Siegburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmut","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Helios Heart Center Siegburg, Siegburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossien","family":"Alirezai","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Helios Heart Center Siegburg, Siegburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eissa","family":"Alaj","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Bakhtiary","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,15]]},"reference":[{"key":"2022010923091128200_ivab228-B1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/j.0886-0440.2004.4057_11.x","article-title":"Evolution of redo cardiac surgery: review of personal experience","volume":"19","author":"Cohn","year":"2004","journal-title":"J Card Surg"},{"key":"2022010923091128200_ivab228-B2","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1016\/j.jtcvs.2010.07.086","article-title":"Identifying patients at particular risk of injury during repeat sternotomy: analysis of 2555 cardiac reoperations","volume":"140","author":"Park","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022010923091128200_ivab228-B3","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1510\/icvts.2009.232090","article-title":"Is resternotomy in cardiac surgery still a problem?","volume":"11","author":"Morales","year":"2010","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2022010923091128200_ivab228-B4","first-page":"219","article-title":"Chirurgie a Coeur overt par video-chirurgie et minithoracotomie. 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