Operative Planning for Safe Endoscopic Mitral Valve Surgery

The increasing interest in minimally invasive approaches has induced fast expansion of minimally invasive mitral valve surgery (MIMVS) over the past two decades. However, MIMVS is not included in the most recent valvular heart disease guidelines due to the lack of convincing data supporting this approach. Due to the different techniques applied by individual surgeons and centers, there has been no scientific nor expertise-based consensus developed regarding standardization in MIMVS and consequently its absolute contraindications. Therefore, a change of mindset is required to shift the focus from the superiority of a procedure toward which particular patients have the greatest benefit from specific surgical approaches. In light of personalized medicine, we have developed a standard procedural planning to ensure a standard approach to patients undergoing MIMVS.