Surgical approach for cardiac surgery in a patient with tracheostoma
Legarra J.J., Sarralde J.A., López Coronado J.L., Trenor A.M.
Department of Cardiovascular Surgery, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
The thoracic approach for cardiac surgery in a patient with a tracheostoma can result in difficult problems, such as mediastinitis, stoma necrosis or inadequate operative exposure.
We present a distinct approach consisting of an incision at the second intercostal space, transverse sternum transection and longitudinal median sternotomy to the xiphoid process, performed for coronary artery bypass grafting and aortic valve replacement, in a patient with previous tracheotomy.
This approach permitted adequate surgical exposure for cardiopulmonary bypass, aortic valve replacement and coronary revascularization procedures.
CITATION Eur J Cardiothorac Surg. 1998 Sep;14(3):338-9