The Minimally Invasive Right Vertical Infra-axillary Lateral Minithoracotomy Approach For The Heart Valve Surgery: Report of 115 Cases

Objective:We have developed a minimally invasive technique for heart valve replacements through a lateral minithoracotomy via a small right infra-axillary skin incision, and have evaluated its initial results. Methods: Through right vertical infra-axillary lateral minithoracotomy incision (by third intercostal space), 106 patientswith rheumatic heart valve disease underwent heart valve surgery, 4 patients with left atrial myxsoma and 5 patient with large atrial septal defect underwent open heart operation are included in this study from July 2012 to December 2015.Results: 42 isolated mitral valve replacements, 7 mitral valve replacements and DeVega tricuspid annuloplasty, 3 mitral and tricuspid valve replacement, 2 mitral valve replacement and right coronary artery bypass graft, 1 reoperative mitral valve replacement due to dejeneration of the bioprothesis of the mitral valve, 6 mitral valve repair, 1 mitral valve repair and aortic valve replacement; 33 isolated aortic valve replacements, 9 aortic and mitral double valve replacements, 2 triple valve replacements, 4 excision of the left atrial myxsoma and 5 surgical closure of the large atrial septal defect were performed.There were 52 women (45%) and 63 men (55%).The mean and range of age was 48±9 (14-91).The length of the incision averaged 8.5±0.5 cm, There were 4 operative mortalities, one patient from infective endocarditis and multisystem organ failure, the other patients from cardiac failure in the hospital.The results of follow up for other patients were fine.Conclusions: This minimally invasive right vertical infra-axillary lateral minithoracotomy approach is safely, practicable, useful, economic, small wounded, cosmetic, contemporary and modern approach for the heart valve surgery