Abstract
INTRODUCTION: Cardiac surgery in patients with osteogenesis imperfecta is a high-risk procedure because of tissue fragility, which leads to complications, such as bleeding, fractures, and increased mortality. A less invasive approach, such as right anterior mini-thoracotomy, may help reduce these risks and improve outcomes. CASE PRESENTATION: A 36-year-old woman with severe aortic regurgitation was referred for surgery. She had type I osteogenesis imperfecta, which was diagnosed based on childhood fractures, deafness, and a family history of the disease. To avoid sternotomy and minimize the risk of fracture, aortic valve replacement was performed through a small right anterior thoracotomy using a wound retractor instead of a thoracotomy device. A 23-mm mechanical valve was implanted with cross-clamp and cardiopulmonary bypass times of 62 and 107 min, respectively. The patient's postoperative course was uneventful. At the 2-year follow-up, she remained in good condition, with no significant echocardiographic findings. CONCLUSIONS: For patients with osteogenesis imperfecta, the right anterior mini-thoracotomy approach is an excellent surgical option that may help improve outcomes.