الفهرس 
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Abstract
Introduction: The lateral thoracotomy approach for mitral valve surgery was used extensively in the early history of open-heart surgery. This study compared the procedure and early postoperative outcome of the classic right thoracotomy approach for mitral valve surgery versus the minimally invasive approach through right anterolateral mini-thoracotomy. Intraoperatively, there was no statistically significant difference in the cross-clamp time, total bypass time, but there was a significant difference in total operative time, this was attributed to the need for acquiring experiences in MIMVS and the lack of adequate instrumentation.
Objectives: This review aims To review the evolution and evaluate advantages and disadvantages of right anterolateral thoracotomy(classic right thoracotomy) as compared to most recent trends and techniques in the field of (minimal invasive) mitral valve procedures.
Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018.
Study selection: This search presented 57 articles. The articles studied minimally invasive (limited anterior thoracotomy) versus right thoracotomy for mitral valve surgery.
Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.
Data Synthesis: Comparisons were made by structured review with the results tabulated.
Conclusions: In our less invasive study group, we achieved less mediastinal drainage and blood loss, thereby less blood and blood products were required for transfusion. The ICU stay and hospital stay were significantly shorter with MIMVS, and there were fewer incidences of major complications such as wound infection and with better postoperative pulmonary functions, and consequently faster recovery and back to normal activity.