An alternative surgical approach to redo pulmonary valve replacement: the vertical left axillary thoracotomy.

Redo cardiac surgery is often needed for right ventricular outflow tract complications after tetralogy of Fallot repair. Common approaches include redo sternotomy or anterior thoracotomy. We report a case of pulmonary valve replacement performed via vertical left axillary thoracotomy, which effectively minimises cardiac injury risk during reentry and offers a safe, cosmetic alternative to conventional thoracotomy approaches.