Right Thoracotomy Approach to Mitral Valve Surgical Procedures

ABSTRACT The right thoracotomy approach to mitral valve surgical procedures allows surgeons to achieve excellent, rapid exposures of mitral annuli; facilitates the excision of diseased mitral valves; avoids injury to previously placed coronary artery bypass grafts; and aids surgeons with the insertion of valve prostheses. This approach is especially appropriate for patients with anatomic deviations (eg, deep chest cavities, counterclockwise rotations of the heart) and hostile mediastina (ie, previously opened mediastina with severe adhesions around the heart and posterior side of the sternum). This article discusses mitral valve disease, compares the right thoracotomy approach to median sternotomy, describes perioperative nursing care of patients undergoing mitral valve surgical procedures, and presents a case study. AORN J 65 (Feb 1997) 347–364.