title: Video-atlas on minimally invasive mitral valve surgery-The David Adams technique.
abstract: Median sternotomy has unquestionably evolved over recent decades. Modern sternotomy involves a 7-8 cm lower midline skin incision, tunneling of the subcutaneous tissues with subsequent creation of myocutaneous flaps, full sternotomy, and standard cardiopulmonary bypass techniques with central cannulation. In experienced centers, modern sternotomy may achieve all the goals of minimally invasive surgery, including excellent cosmesis, excellent postoperative pain control, low rates of bleeding and transfusion (our re-exploration rate for bleeding is <1%), and the ability to perform any reconstructive technique that would be used in a standard sternotomy, with very high repair rates (our most recent series documented a repair rate exceeding 99% in an all-comers population of degenerative disease regardless of complexity).
authors.affiliation: Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, New York, New York, USA.
authors.forename: Javier G
authors.initials: JG
authors.lastname: Castillo
authors.affiliation: Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, New York, New York, USA.
authors.forename: Federico
authors.initials: F
authors.lastname: Milla
authors.affiliation: Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, New York, New York, USA.
authors.forename: Anelechi C
authors.initials: AC
authors.lastname: Anyanwu
authors.affiliation: Department of Cardiothoracic Surgery, The Mount Sinai Medical Center, New York, New York, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Adams
keywords: Modern sternotomy; complex mitral valve repair