Mitral Valve Procedures and Multivessel CABG through a Single Left Anterior Minithoracotomy

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Thoracic Surgery

Background:

• Concomitant coronary artery bypass grafting (CABG) and mitral valve (MV) procedures are often necessary.
• Traditional sternotomy approaches for these combined surgeries carry significant morbidity.
• Minimally invasive techniques are sought to reduce surgical trauma and improve patient outcomes.

Purpose of the Study:

• To describe a novel technique for performing combined CABG and MV surgery.
• To evaluate the feasibility and safety of a single left anterior minithoracotomy (LAmT) approach for these procedures.
• To assess the efficacy of a transseptal approach for mitral valve access during LAmT.

Main Methods:

• A single left anterior minithoracotomy (LAmT) approach was utilized.
• Peripheral cardiopulmonary bypass was employed for circulatory support.
• A transseptal approach facilitated mitral valve (MV) exposure for replacement or annuloplasty.
• Complete coronary revascularization was performed concurrently.

Main Results:

• The combined MV and CABG surgery was successfully completed in all four patients via LAmT.
• Excellent mitral valve exposure was achieved without the need for sternotomy conversion.
• No major complications, including stroke, reoperation for bleeding, or early mortality, were observed.
• The technique demonstrated feasibility as a sternum-sparing option.

Conclusions:

• Single LAmT is a feasible and safe approach for simultaneous coronary artery bypass grafting (CABG) and mitral valve (MV) procedures.
• This sternum-sparing technique offers a minimally invasive alternative for selected patients.
• Further investigation is warranted to establish the long-term benefits of this approach.