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Background: Management of moderate functional tricuspid regurgitation (FTR) secondary to left-sided valve lesion is controversial. The objective of this study was to compare the short-term results of surgical repair versus conservative treatment for moderate functional tricuspid regurgitation in concomitant with mitral valve surgery. Methods: Our study included 60 patients with mitral valve lesion and moderate functional tricuspid regurgitation. Patients were divided into 2 groups; group A included 30 patients whose tricuspid valve disease were managed conservatively, and group B included 30 patients who had tricuspid valve band annuloplasty. Results: Preoperative clinical and echocardiographic data were comparable between groups. There was no difference regarding mechanical ventilation time (6 .13 ± 3.02 vs. 7.01 ± 4.14 hours; p= 0.291), or intensive care unit stay (51.42 ± 12.1 vs. 52.31 ± 15.32 hours; p=0.614) in group A and B respectively. There was a significant improvement in the degree of tricuspid valve regurgitation in group B early postoperative (moderate tricuspid regurgitation reported in 22 (73.3%) vs. 4 (13.3%); p<0.001) and at 3 months (moderate tricuspid regurgitation 11 (36.7%) vs. 2 (6.7%); p<0.001) and 6 months follow up (moderate tricuspid regurgitation 10 (30%) vs.  2 (6.7%); p<0.001) in group A and B respectively. After 6-months, 20 (66.7%) patients in group A had dyspnea grade I compared to 26 (86.7%) patients in group B; p=0.021. Conclusion: Although the correction of the left-sided lesion improved the degree of TR in some patients, concomitant repair of the tricuspid valve could produce better improvement in the clinical outcome when compared to the conservative approach.

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Introduction: Minimally invasive approach to Aortic Valve Replacement (AVR) is increasingly accepted as a valid alternative to full sternotomy approach, as to reduce operative trauma with the final aim to improve post-operative outcomes. The aim of this work is to evaluate the feasibility of minimally invasive aortic valve surgery through a right mini-thoracotomy, and hence to minimize the surgical access to achieve better cosmetic results, less postoperative discomfort and faster recovery while maintaining the same level of safety and favorable results as with conventional surgery. Methods: In this study a 150 patients with Aortic Valve Disease (AVD) requiring aortic valve surgery were none randomly selected. The study was performed at Benha University Hospital & the Armed Forces Hospitals. Seventy five patients underwent aortic valve surgery by traditional median sternotomy with central cannulation (group B), the other seventy five patients by right mini-thoracotomy on 2 nd or 3 rd right intercostal space with peripheral femoral cannulation (group A). Endpoints were overall postoperative complications, major adverse cardiac related complications, use of blood products and need for transfusions, bypass time and cross clamp time, ventilation time and length of hospital-stay. Results: Minimally invasive AVR was associated with a significant reduction in need for blood and blood products transfusions, as well as postoperative cardiac and non-cardiac complications. Post-operative pain was significantly reduced in the mini-invasive group, a trend to lower mean ventilation times, ICU stay and hospital-stay in the miniinvasive group was also detected. Conclusion: Minimally invasive aortic valve surgery has evolved into a well tolerated, efficient surgical treatment option in experienced centers, providing greater patient satisfaction and lower complication rates. Potential advantages of Minimally Invasive Aortic Valve Replacement (MIAVR) arise from the concept that patient morbidity and potential mortality could be reduced without compromising the excellent results of the conventional procedure and include improved cosmetic results, safer access in the case of re-operation, less postoperative bleeding, less blood transfusions, lower intensive care unit and in-hospital stays, as well as the absence of sternal wound infection.