FIRST OPEN-HEART OPERATION (MITRAL VALVUL OPLASTY) UNDER VIDEOSURGERYTHROUGH A MINITHORACOTOMY

The development of ''less invasive surgery'' using small incisions and videoscopic techniques may change, in the near future, our attitude t owards ''traditional'' surgery. This is because of specific advantages such as skin limited incisions, reduced perioperative disability and lower cost. Up to now, only abdominal, thoracic and coronary artery su rgery which do not imply the opening of the heart, or closure of simpl e atrial septal defects, have benefitted from this new approach. This article reports the first case of open heart surgery for complex lesio ns of the left heart through a minithoracotomy (5 x 4 cm) with the use of videotransmission and peripheral extracorporeal circulation. The p atient, a 30-year-old female, was operated upon for a combined mitral valve stenosis and insufficiency of rheumatic origin unsuccessfully tr eated by a previous percutaneous valve dilatation. The 2.5 h open hear t procedure comprised commissurotomy, repair of torn leaflets, chordal transposition and Carpentier-Edwards prosthetic ring implantation. Th e patient left the hospital 12 days after the operation. Transesophage al echocardiography at discharge showed normal valve function with no residual stenosis or residual leak.