The right vertical infra-axillary incision for mitral valve replacement

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Thoracic Surgery

Background:

• Increasing focus on cosmetic outcomes in valve surgery.
• Development of alternatives to median sternotomy for mitral valve surgery.
• Need for minimally invasive and aesthetically pleasing surgical options.

Purpose of the Study:

• To report a novel minimally invasive and cosmetic approach for mitral valve replacement.
• To evaluate the safety and efficacy of the right vertical infra-axillary incision (RVIAI) technique.

Main Methods:

• Retrospective analysis of 256 patients undergoing mitral valve replacement using RVIAI from December 2003 to December 2009.
• Inclusion of patients receiving mechanical or bioprosthetic valves.
• Concurrent tricuspid valvuloplasty performed in 28.1% of patients.

Main Results:

• Low incidence of adverse events: one hospital death (multiple organ failure), one reoperation (bleeding), and one incision infection.
• High follow-up rate (94%) with a mean duration of 42.8 months.
• Absence of paravalvular leaks or late mortality during follow-up.

Conclusions:

• The RVIAI approach for mitral valve replacement yields favorable cosmetic and clinical results.
• RVIAI is a safe and effective alternative to standard median sternotomy for selected MVR patients.
• This technique addresses the growing demand for aesthetically improved cardiac surgical procedures.