The left XXXX : an asset for minimally invasive mitral valve surgery.

@entity1 @entity339 @entity955 @entity299
BACKGROUND: The focus in minimally invasive mitral valve surgery has been on reducing thoracic incisions. Several cardiac incisions described in these procedures do not conform with the philosophy of "minimal invasiveness". We describe the left @entity955 which has the potential of facilitating an excellent mitral valve exposure through a limited cardiac incision, without major @entity299 . The safety, efficacy and technical ease of this technique for minimally invasive mitral valve surgery is evaluated. METHODS: From July 1998 to December 2000, 95 consecutive @entity1 underwent mitral valve surgery by the same surgeon. The @entity1 were divided into 2 groups on the basis of the cardiac incision used for correction of @entity339 . Group I @entity1 had left @entity955 and group II @entity1 had the traditional paraseptal incision. Each group was further classified into the minimally invasive sternotomy and standard sternotomy subgroups. The clinical variables and complications in the 2 groups were compared. RESULTS: There were 40 male and 55 female @entity1 with a mean age of 63 +/-12yrs (range 29 to 88yrs). LARI was used for mitral valve exposure in 81 @entity1 (85%). In 18 @entity1 (19%), surgery was by minimally invasive technique. The mitral valve was replaced in 82% of @entity1 and repaired in 18%. LARI provided a better exposure of the mitral valve in its anatomical and physiological disposition, without distortion. There was no significant difference in the cross clamp times and postoperative complications between the 2 groups. More @entity1 in the LARI group regained sinus rhythm at discharge. CONCLUSION: LARI is safe and technically easy to perform. It provides an excellent exposure of the mitral valve and left heart cavities in its anatomical disposition with minimal @entity299 , making it ideal for minimally invasive mitral surgery.
