Redo Aortic Valve Replacement via Right Thoracotomy to Address Strong Adhesion of the Vascular Graft to the Posterior Sternum: A Case Report

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We report a redo aortic valve replacement via right thoracotomy in a 75-year-old woman with Marfan syndrome and prior total arch replacement via median sternotomy. Preoperative computed tomography revealed strong adhesion between the vascular graft and the sternum. Considering the high risk of bleeding and complications associated with resternotomy, we selected the right thoracotomy approach. Although the patient required prolonged postoperative respiratory rehabilitation, she is now living actively and walking independently at approximately 500 days postoperatively. This case demonstrates that right thoracotomy approach is an effective option for reoperation involving strong adhesion of the vascular graft to the posterior sternum.

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