Redo -tricuspid valve replacement, technical consideration; valve in valve insertion

With increasing life expectancy, as the general population ages, reoperation for valvular
heart disease continue to increase. Structural failure of bioprosthesis and progression of
native valve disease are leading causes of reoperation in tricuspid position (1). Reoperation
is technically more difficult than primary operation and has been associated with
higher mortality due to adhesion, the presence of more advanced cardiac pathology and
the existence of more frequent co-morbidity. Peripheral cannulation, right thoracotomy
and alternative surgical technique can be used to decrease mortality and morbidity