The Heart Valve Society

Back to 2017 Program


A New Approach for Minimally Invasive Mitral Valve Surgery: The Periareolar Access
Robinson Poffo, Paola K. Montanhesi, Alisson P. Toschi, Renato B. Pope, Claudio A. Mokross.
Hospital Isrealita Albert Einstein, Sao Paulo, Brazil.

OBJECTIVES: Describe an unprecedented route to video-assisted minimally invasive mitral valve surgery, combining the effectiveness of this method to a route on which manipulation of the mitral valve is optimized: the periareolar access.
METHODS: Between February 2006 and October 2016, 214 patients underwent video-assisted minimally invasive cardiac surgery using the periareolar access. The cardiac pathologies approached were: mitral valvopathy (n=132), atrial septal defect (n=74), 24 patients presented associated tricuspid insufficiency, 35 presented associated atrial fibrillation. Eight patients had surgical extraction for pacemaker leads endocarditis. The age ranged from 18 to 72 years and 145 were female. The surgical approach was: femoral arterial and venous cannulation or right jugular vein cannulation, minithoracotomy on the right periareolar region, through the right breast and thoracoscopy.RESULTS: From the mitral valve pathology cohort (n=132) it was possible to perform mitral valve plasty in 95 patients and mitral valve replacement in 37 patients. There were no complications during the procedures. There was no conversion to thoracotomy in neither cases. There were no complications related to the surgical healing of the periareolar access or peripheral cannulation.CONCLUSIONS: The periareolar access is safe and effective and can be used for video-assisted minimally invasive mitral valve surgery. It demonstrates excellent aesthetic and functional results.


Back to 2017 Program