A good vision of the mitral apparatus affects the success of the surgeon in mitral valve surgery, especially in reoperations and mitral valve repairs. In cases when conventional left atriotomy is not enough for a good vision of the area transseptal or superior septal approaches are commonly used. In this study, operated 95 cases managed via transseptal(60) or superior septal (35) approach are studied retrospectively. In superior septal approach, the ejection fraction values are higher and left atrial diameters are larger. In transseptal group the number of reoperated cases and concomitant tricuspid valvular diseases are higher. In both groups the cross clemp and bypass time are similar. There are no significant differences in mortality, postoperative bleeding and infection incidance, blood transfusion amount, intensive care and internalization durations between the two groups. The ECG findings both in the postoperative first hour and at the externalization, show that the sinus rhythm is more common in the transseptal group than the superior septal group. Temporary pacemaker need is less in the transseptal group. There are no significant differences between the preoperative and externalisation ECG findings in each patient groups with sinus rhythm and atrial fibrillation . In maintaining a good vision of mitral area in mitral valve surgery, especially in the presence of small left atrium, reoperations and mitral valve repairs, transseptal or superior septal approach are good alternatives. Nevertheless, it should be kept in mind that postoperative atrial rhythm problems can be seen especially in cases managed with superior septal approach.

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