الفهرس 
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Abstract
The lateral thoracotomy approach for mitral valve surgery was used extensively in the early history of open-heart surgery. Postoperative sternal wound complications are the major problem with sternotomy incision, other disadvantages of median sternotomy is the bad cosmetic appearance of the scar, which is more prone to keloid formation.
This study was to compare the procedure and early postoperative outcome of the standard sternotomy approach for mitral valve surgery versus the minimally invasive approach through right anterolateral mini-thoracotomy by direct vision.
This study was conducted on 50 patients; All the patients completed the study without mortality. The patients were classified into 2 groups:
group A: minimally invasive group. This group included 25 patients requiring mitral valve surgery and was approached through a right Anterolateral video-assisted minithoracotomy.
group B: Sternotomy group. This group included 25 patients requiring mitral valve surgery and was approached through a conventional median sternotomy.
There was no statistically significant difference as regards the age, sex, NYHA, preoperative echocardiographic findings also preoperative Spirometric study revealed no statistical significance.
Regarding intraoperative comparison, there was no statistically significant difference in the cross-clamp time, total bypass time, but there
is a significant difference in total operative time, this difference may be due to the new experiences in MIMVS.
The length of the incision was highly significantly lesser in group “A” than in group “B”, There was significant difference in the intensive care parameters. The mechanical ventilation time was shorter in group “A”, the blood loss and the blood transfusion required was lesser in group “A”.
The ICU stay was shorter in group “A”. Postoperative Pulmonary functions were markedly reduced in group “B” than in group “A”, There was highly significantly less postoperative pain in group (A) than in group (B).Total hospital stay was less in group (A) than in group (B).
The complications of group “A” were less serious than those in group “B” but there was no statistical significance. MIMVS was more cost effective than sternotomy group.
MIMVS, if performed through a right anterolateral minithoracotomy would not only be better accepted cosmetically by patients, but also make redo surgery through median sternotomy easy and trouble free from reentry bleeding.