Optimal mitral valve operation requires adequate exposure without impairement of atrial physiology, namely sinüs node and atrioventricular node function. We used the trasseptal superior approach (TSS) in 11 consecutive patients. The trasseptal superior approach combines two atrial incisions circumscribing the tricuspid and mitral annuli anteriorly and superiorly, allowing exposure of the mitral valve by deflecting the ventricular side using stay sutures. The right atrium was opened obliquely lateral from the inferior venous cannula to the the appendage. The atrial septum incised vertically through the fossa ovalis. The right atriotomy is extended superiorly in the right coronary fossa between the right atrial apendaage and the atrioventricular sulcus to meet the septal incision. The two joint incisions are extended onto the left atrial roof transversely. There were 8 men and 3 women. One patient had ASD and mitral stenosis, 3 had mitral valve disease, 3 had double valve disease and 4 had triple valve disease. Six of 11 patients had atrial fibriltation and the others had sinüs rhythm preoperatively. All the patients had the same rhythm postoperatively. There were no accident. The trasseptal superior appoach provides good mitral valve exposure without inherent complications.

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