• Mohammad H Nezafati, Pouya Nezafati, Mahmoud Hosseinzadeh, and Sahar Omidvar Tehrani.
• Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Pouya_dg@yahoo.com.
• Asian Cardiovasc Thorac Ann. 2015 Mar 1; 23 (3): 271-4.

BackgroundTo reduce the morbidity of mitral valve operations, a right anterolateral minithoracotomy under direct vision was introduced. We report our experience with this procedure.MethodsFrom July 2001 to December 2013, 320 consecutive patients underwent direct minimally invasive mitral valve surgery through a right anterolateral minithoracotomy at our institution. Evidence of rheumatic disease was observed in 231 (72%) patients, and 89 (28%) repaired valves had myxomatous changes. Tricuspid valve repair was performed in 80 (25%) patients and radiofrequency ablation in 80 (25%) with chronic atrial fibrillation. All cannulas were introduced through the thoracotomy incision, eliminating femoral cannulation. No new instruments, retractors, or ports were used. Pleural and pericardial drainage was accomplished through a single drain.ResultsThere was no hospital death. Conversion to sternotomy was needed in 3 patients because we were unable to obtain satisfactory arterial cannulation. Eight patients required reoperation: 7 for mitral insufficiency and one for postoperative bleeding. Mean cardiopulmonary bypass and crossclamp times were 55.3 ± 17.0 and 43.0 ± 13.4 min, respectively. Mean intensive care unit stay was 29 h, and hospital stay was 4.3 days.ConclusionsBased on our experience, this minimally invasive approach is safe, rapid, cost-effective, and more comfortable for the patients, in addition to its cosmetic benefits. It may be the preferred approach in young females.© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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