Mitral Valve Replacement Under Video Assistance Through a Minithoracotomy

Minimally-Invasive Valve Surgery

“…Thus, mini-VS has evolved into a routinely performed operation with excellent results in many specialized centers (13,(21)(22)(23)(24).…”

“…Chitwood et al (16) designed a new aortic clamp that allows transthoracic aortic occlusion. Video assistance has also been used for mini-VS through small thoracotomies (17,21,22). Although there are highly encouraging results using a right thoracotomy, several disadvantages exist, including peripheral CPB cannulation, the need for a double-lumen endotracheal tube, and occasional difficulty with MV exposure (21).…”

“…Video assistance has also been used for mini-VS through small thoracotomies (17,21,22). Although there are highly encouraging results using a right thoracotomy, several disadvantages exist, including peripheral CPB cannulation, the need for a double-lumen endotracheal tube, and occasional difficulty with MV exposure (21). Another important technique is the port access for mini-MVS (30), with promising results (31)(32)(33)(34).…”

Access to the Heart – Evolution of surgical techniques

“…Over the past 8-10 years, increased interest in minimally invasive approaches to the heart have encouraged the development of left minithoracotomy procedures for CABG and left ventricular epicardial lead implant procedures. Right minithoracotomy approaches have been developed with great success, for mitral valve procedures [17], tricuspid valve procedures [18] and aortic valve procedures. The exact location of each of these incisions may vary according to patient habitus, valve location, previous cardiac history and anatomical features (as detected by pre-operative or intra-operative imaging).…”

Is minimally invasive heart valve surgery a paradigm for the future?

“…Video assistance has also been used to advantage for mitral valve surgery through a small thoracotomy [16•,18,19]. Although good results have been obtained with a right thoracotomy, disadvantages include peripheral cannulation for CPB, the need for a double lumen endotracheal tube, and occasional difficult exposure of the mitral valve [19].…”