Less invasive mitral valve surgery via right minithoracotomy.

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Cardiac surgery trends favor less invasive approaches, including smaller incisions and beating-heart techniques.
• Limited data exists on the efficacy, safety, and cosmetic results of newer, less invasive cardiac surgical methods.

Purpose of the Study:

• To analyze the outcomes of a sternum-sparing mitral valve operation.
• To evaluate the safety, efficacy, and cosmetic results of this minimally invasive technique.

Main Methods:

• Thirty patients with mitral valve disease underwent either repair (20) or replacement (10) using a sternum-sparing approach.
• Femoral cannulation for cardiopulmonary bypass and percutaneous transthoracic cross-clamp were employed.
• The primary incision was over the right breast's lateral border, with additional small ports for instrumentation.

Main Results:

• No operative mortality was observed, with all patients recovering uneventfully.
• Associated procedures included tricuspid valve annuloplasty/replacement and atrial septal defect repair.
• Mean incision length was 7.1 cm; mean bypass and cross-clamp times were 91.1 and 43.7 minutes, respectively.
• Satisfactory results and good cosmesis were achieved, though length of stay was not significantly reduced compared to median sternotomy.

Conclusions:

• Sternum-sparing mitral valve surgery is a safe and effective alternative to conventional median sternotomy.
• This approach is less invasive and yields superior cosmetic results for patients.