Redo cardiac surgery: the surgeon's point of view

Redo cardiac surgery is still challenging and carries a higher mortality and morbidity. Often and particularly in valvular surgery, patients are referred too late with an increase operative risk due to co-morbidity and advanced cardiac disease. Pre operative improvement of patient's general conditions is a key point and the surgical strategies must be adapted to the previous procedure as to the surgery planned. Redo procedure after previous coronary surgery is the most complex situation. Mini-invasive surgical approaches as alternative to re-sternotomy have to be emphasized, specially in mitral or tricuspid surgery; as a new surgical standard. (C) 2009 Elsevier Masson SAS. All rights reserved.