Beating Heart Video-Assisted Mitral Valve Surgery: A Useful Technique for High-Risk Patients

Abstract   Background: Beating-heart valve surgery through a sternotomy has been used as an excellent myocardial protection strategy in high risk patients. Minimally invasive approaches have reduced the trauma and enhanced the recovery of patients undergoing heart surgery. We hypothesized that high-risk patients undergoing mitral valve surgery will benefit from a combination of these two approaches. Methods: A 52-year-old male with dilated cardiomyopathy and left ventricular function of 15% was referred for surgery because of congestive heart failure. Results: Using a 4-cm right minithoracotomy and femoral cannulation for cardiopulmonary bypass, successful beating-heart video-assisted mitral valve repair was performed. The adequacy of myocardial protection was confirmed by absence of ischemic electrophysiologic changes. The patient was discharged home on the 6^th postoperative day. Conclusion: Beating-heart strategy can be combined with a minimally invasive approach in patients with severely reduced ventricular function, who require mitral valve surgery.