Two cases of valve surgery through right anterior minithoracotomy in presence of severe postmastectomy irradiation sternal damage.

High dose postmastectomy radiation therapy for breast cancer can lead to severe postirradiation sternal damage. Under these circumstances, median sternotomy may be associated with a prohibitive risk of postoperative deep sternal wound infection and alternative approaches have to be evaluated. We report herein the use of a right anterior minithoracotomy through the third intercostal space for isolated aortic valve replacement in one and combined aortic and mitral valve replacement in combination with mitral ring decalcification and coronary artery bypass grafting to the proximal right coronary artery in another patient.