Less Invasive and Video-Assisted Mitral Surgery at a Crossroads

Dear Colleagues,

Cardiac surgery has been the last of the surgical fields to adopt minimal invasive techniques. After the introduction of endoscopic techniques into general surgery in the late 1980s, and later into other surgical specialties such as gynecology and thoracic surgery, minimally invasive cardiac surgery began in the 1990s.

Heart surgery procedures are both complex and invasive. These later characteristics, over time, presented a problem in terms of transforming cardiac surgeries in minimally invasive procedures; however, as the same time, they also presented an opportunity and a motivation. Initial efforts concerned coronary artery bypass surgery. Currently, mainly other cardiac procedures are being achieved by minimally invasive approaches. These include mitral valve surgery, aortic valve replacement, and treatment of atrial fibrillation.

In recent years, minimally invasive mitral surgery has evolved to a point where it might be more beneficial than conventional procedures. These new approaches have improved both morbidity and mortality rates. Additionally, patient approval is greater due to superior cosmetic results, shorter hospitalization, and lesser restriction of physical activities and, consequently, decreased overall cost. The rapid progress in video-assisted surgery using 30° or 120° video scopes also with 3D technology accelerated the evolution of a minimally invasive approach to cardiac surgery that has now become a reality.

The debate continues concerning the role of less invasive surgery mitral surgery. Opponents of minimally invasive cardiac surgery point at an increased learning curve, prolonged operative times, and versatility to address complex mitral pathology. However, excellent results are currently being achieved in term of morbidity and mortality, in addition to outstanding long-term outcomes.

The aim of this Special Issue is to discuss and highlight topics and findings on less invasive and video-assisted mitral surgery with the most authoritative surgeons around the world. This may also be an opportunity for cardiac surgeons and cardiologists to provide their area of knowledge.

Prof. Dr. Ernesto Greco
Guest Editor

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• videoscopy mitral surgery
• micro-incision
• minimally invasive mitral valve repair
• invasiveness
• video-assisted technology