Table 4. A summary of surgical techniques performed during mitral valve surgery through mini-mitral or sternotomy approaches.
| Author | Mini-mitral access approach | Mini-mitral clamp technique | Cardioplegia |
Mitral-valve repair details |
Concomitant surgery |
Conversion to sternotomy | |||
|---|---|---|---|---|---|---|---|---|---|
| Mini | Stern | Mini-mitral | Sternotomy | Mini-mitral | Sternotomy | ||||
| Goldstone | 4 cm right thoracotomy in infra-mammary grove | Aortic cross-clamp or endoballoon | AG & RG | Annuloplasty (5/153); leaflet resection (98/153); neochordae (29/153) | Annuloplasty (10/153); leaflet resection (121/153); neochordae (15/153) | NR | NR | NR | |
| Speziale | 2 ports & 4-5 cm right anterolateral mini-thoracotomy 3rd ICS & 5-7th ICS | Aortic cross-clamp | AG | NR | Annuloplasty & artificial chordal re-implantation | Annuloplasty & artificial chordal re-implantation | AF ablation (11/70) | AF ablation (12/70) | 1/70 (inadequate exposure) |
| Ryan | 4 cm incision 4th right ICS with port access | Endoballoon | AG & RG | Annuloplasty, chordal replacement and/or leaflet resection and sliding-plasty as required | Annuloplasty, chordal replacement and/or leaflet resection and sliding-plasty as required | NR | NR | 2/177 (repair of coronary sinus) |
|
| Raanani | 3 ports & 6-8 cm infra-mammary fold incision | Aortic cross-clamp or endoballoon | AG | AG & RG | Annuloplasty (61/61); leaflet resection (46/61); Alfieri edge-to-edge (6/61); artificial chordae (16/61) | Annuloplasty (82/82); leaflet resection (66/82); Alfieri edge-to-edge (1/82); artificial chordae (27/82) | NR | NR | 0/61 |
| Suri | 4 cm right infra-mammary incision with port access | Aortic cross-clamp or endoballoon | AG | NR | NR | NR | PFO closure | PFO closure | NR |
| Ruttman | 5-6 cm right anterolateral incision 4th ICS & port access ICS | Aortic cross-clamp OR endoballoon | AG & RG | NR | Ring annuloplasty (41/41); artificial chordae (7/41); rectangular resection p2 segment (22/41) | Ring annuloplasty (64/64); artificial chordae (7/64); rectangular resection p2 segment (41/64) | PFO closure (1/41); AF ablation (1/41) |
PFO closure (1/64); AF ablation (12/64) | 1/42 (repair bleed from aorta) |
| Grossi | Right thoracotomy & port access | Endoballoon | RG | NR | Ring annuloplasty | Ring annuloplasty | NR | NR | NR |
AG, antegrade; RG, retrograde; NR, not reported; PFO, patent foramen ovale; AF, atrial fibrillation; ICS, intercostal space.