Mitral Valve Repair via a Minithoracotomy in a Patient With Pectus Excavatum

Cardiac surgery in patients with pectus excavatum is challenging because of the difficulty associated with achieving optimal surgical exposure and postoperative sternal fixation by using standard instruments. To solve these problems, mitral valve repair was performed via a right minithoracotomy in a 48-year-old man with severe mitral valve regurgitation and pectus excavatum. With the use of conventional median sternotomy, an optimal surgical field was difficult to achieve because of his thoracic deformity. Therefore, surgical fixation via right minithoracotomy using particular equipment was performed. Using right minithoracotomy, we could obtain an optimal surgical field better than that with median sternotomy, and the patient's mitral valve regurgitation was fixed properly. This approach provides mitral valve exposure advantages as well as cosmetic satisfaction.