الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
In our study 60 cases were operated 30 cases of them were operated by minially invasive approaches, 22 cases of mitral valve replacement , 8 cases of secondum ASD patch closure all cases were operated via very limited anterolateral mini thoracotomy video assisted. The other group of cases were operated by conventional sternotomy.cardio pulmonary by pass time and cross clamp time are longer in minimal invasive group than conventional group Minimaly invasive group showed no mortality,no failure or sternotomy conversion,no wound infection,two cases needed rexploration for bleeding with much reduced post operative pain although total ventilation time is much lower in minimal invasive group,total ICU stay,total hospital stay,total blood loss and blood transfusion were lower in minimaly invasive than sternotomy group. So we can say that minimally invasive surgery is safe as conventional and efficient with other mentioned differences minimally invasive surgery should be offered for any patient who meet the inclusion criteria , Minimaly invasive surgeries have exclusive advantages like re do surgery for valve replacement after CABG as thoracotomy protect patent by pass graft especially LIMA which is vulnerable for injury with redo sternotomy ,