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Eur J Cardiothorac Surg 1999;14:338-339
© 1999 Elsevier Science NL

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Surgical approach for cardiac surgery in a patient with tracheostoma

Department of Cardiovascular Surgery, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain

Received 30 March 1998; received in revised form 17 June 1998; accepted 22 June 1998.

Corresponding author. Marie Curie 1, 1 D, 14011 Córdoba, Spain. Tel.: +34 919 222925.

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.

Key Words: Cardiac surgery • Tracheostoma • Thoracic approach

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