title: Surgical repair of mitral valve prolapse through a minimal right vertical infraaxillary thoracotomy.
abstract: BACKGROUND
  Minimally invasive mitral valve surgery has been proven a safe and cosmetic alternative to the conventional median sternotomy approach. The aim of this study is to retrospectively evaluate the clinical outcome of mitral valve repair for leaflet prolapse through a minimal right vertical infraaxillary thoracotomy (RVIAT).
  
  
  METHODS
  From January 2003 to December 2011, 68 patients with mitral regurgitation (MR) due to leaflet prolapse underwent mitral valve repair through a RVIAT approach. There were 37 males and 31 females. The mean age of the patients was 37.8 ± 10.5 years. Of the 68 patients, 45 had posterior leaflet prolapse and 23 had anterior leaflet prolapse.
  
  
  RESULTS
  The mean incision length was 7.3 ± 1.8 cm (range 5.5 to 10.0 cm). Mitral valve repair technique included quadrangular resection with or without sliding repair (40 cases), edge to edge technique (six cases), artificial chordae (18 cases), chordal transfer (four cases), and ring annuloplasty was performed in all 68 patients. There was no severe morbidity and operative mortality. Echocardiography after operation demonstrated absence or trivial mitral regurgitation in 52 patients and mild regurgitation in 16 patients. During the 3 months ≈ 8 years' follow-up period, one patient (1.5%) underwent mitral valve replacement through the median sternotomy due to recurrent severe MR. Other patients were in good condition.
  
  
  CONCLUSIONS
  Surgical repair of mitral valve prolapse can be successfully performed through the RVIAT approach achieving excellent cosmetic and clinical results.
authors: Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors: Zhong
authors: Z
authors: Wu
authors: Jun
authors: J
authors: Pan
authors: Qiang
authors: Q
authors: Wang
authors: Qing
authors: Q
authors: Zhou
authors: Dongjin
authors: D
authors: Wang
mesh_terms: D000328:Adult; D001365:Axilla / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods; D002815:Chordae Tendineae / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000601:surgery*; D061646:Operative Time; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome