Mitral valve replacement in a patient with a collapsed lung and a giant abscess.

Mitral valve replacement was performed on a 75-year-old man with a history of pulmonary tuberculosis. Computed tomography showed a collapsed left lung and counterclockwise rotation of the heart due to a hard abscess. Surgery was performed through a median sternotomy, and extensive pericardial suspension was useful for obtaining an adequate view. Despite poor pulmonary function, the patient was extubated on the day of surgery and had an uneventful postoperative course. Cardiac surgery can be performed in patients with a single functional lung if their preoperative respiratory function is good enough to have daily life without dyspnea.