Mitral Valve Repair Through a Right Mini-Thoracotomy After Retrosternal Esophageal Reconstruction

The median sternotomy approach presents significant challenges in patients who have a neo-esophageal conduit through the retrosternal route. We report a case of successful mitral valve repair through a right mini-thoracotomy to avoid injury to the neo-esophageal conduit in a 74-year-old man with a history of retrosternal reconstruction after esophagectomy. Intraoperative direct echocardiography was used to assess the severity of mitral valve regurgitation. Hence, the right mini-thoracotomy approach might be suitable in patients with a history of neo-esophageal reconstruction. In addition, direct intraoperative echocardiography might be useful when transesophageal echocardiography cannot be performed.