The aim of the study was to investigate the advantages of the right mini-thoracotomy approach versus to the median sternotomy for mitral valve replacement.

The 60 consecutive patients undergoing mitral valve replacement (MVR) were included in the study. 30 of them were performed MVR via the median sternotomy and the rest was performed MVR via the right mini-thoracotomy under the cardiopulmonary bypass (CPB). There were 44 women (73.3%) and 16 men (26.6%). The mean age was 37±4.1. During the postoperative 5 days, their postoperative respiratory support requirement, drenage, temperature, analgesic and respiratory phisyotherapy repuirement were recorded.

There were 9 patients (30%) extubated within the first 6 hours in sternotomy group. 9 patients with high temperature atacks (38-39°C) were recorded. 21 patients required postoperative respiratory phisyotherapy. In this group, mean analgesic therapy requirement was 2.8±0.9 days; and postoperative mean drenage was 589±136 cc. In the right minithoracotomy group, there were 26 patients (86.7%) extubated at postoperative 6th hour and 5 patients (16.7%) with high temperature and 5 patients (16.7%) required respiratory phisyotherapy. In this group, their mean analgesic therapy requirement was 1.8±0.8 days and postoperative mean drenage was 351±63cc.

As a result, in mitral valve replacement, right minithoractomomy apporach was very cosmetic and was also superior to the sternotomy according to the postoperative respiratory support, analgesic, respiratory phisyotherapy requirment and postoperative drenage. We believe that minithoracotomy may be good alternative approach to the sternotomy for mitral valve replacement.

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