Abstract

Minimally-invasive surgery is increasingly being utilised in patients with isolated valve disease who do not require concomitant coronary bypass. Minimally-invasive valve surgery has been performed at the Brigham and Women's Hospital, Harvard Medical School since July 1996 and has now been used in over 273 mitral valve operations, primarily valve repairs. The incisions used have evolved; we used a right para-sternal approach at first and have now changed to a lower mini-sternotomy. The operative techniques employed through this incision are identical to those used in a complete sternotomy. Operative mortality in our mitral valve series is zero. There have been five re-operations. The length of hospital stay and amount of blood utilised are both less than with a complete sternotomy. Most importantly, the patients' return to normality after complete recovery was quicker by approximately 2 weeks versus the conventional sternotomy. Minimally-invasive mitral valve surgery is a technique that can be utilised reproducibly for all techniques of repair or replacement.

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