IA. Limited right anterolateral thoracotomy for mitral valve surgery.

doi:10.1510/icvts.2008.180182A We read with interest this collective review of Lydia Richardson and co-workers w1x. The authors focused on whether port-access mitral valve repair reduces the recovery period of patients compared to the conventional sternotomy approach. The 13 papers representing the best evidence on the subject, demonstrated that patients who undergo minimally invasive mitral valve repair have a shorter ICU and total hospital stay than those who undergo the sternotomy approach. This in spite of the longer reported operative time and increase in bypass time being around 30 min. The surgical experience of our group is of a total of 1734 minimally invasive cardiac surgical operations done either via a ministernotomy (921 patients) or a port access technique (813 patients) starting March 1997 to June 2007. We believe that a stronger evidence of advantages in terms of blood losses, complications and eventually hospital stay may be seen in re-do cases. In this group of patients, minimally invasive surgery (via either ministernotomy or port access technique) has reduced operative times. Re-do operation through a median sternotomy, with dissection of the adhesions is time-consuming. Reducing the width of the operative field, as in minimally invasive surgery, the total time of the operation is decreased and may be less than surgery performed by conventional sternotomy w2–4x