ABSTRACT
The success and increasing utilization of laparoscopic approaches for general surgical procedures in the early 1990s fueled an interest in developing minimal access approaches to cardiac surgery. In the same decade, pioneering work from a number of surgeons led to the use of alternative incisions for heart surgery, including parasternal, partial sternotomy, and right thoracotomy or mini-thoracotomy approaches. The development of technology allowing for percutaneous cardiopulmonary bypass (CPB) and more recently aortic occlusion, cardioplegia administration, and venting have also facilitated refinements in minimal access cardiac surgical technique. In the realm of minimal access mitral valve surgery (MAMVS), our preference has been to use the Heartport platform utilizing a right mini-thoracotomy.
