Handling Extensive Mitral Annular Calcification via a Minimally Invasive Right Mini-Thoracotomy Approach

Mitral annular calcification is a chronic and degenerative process of the fibrous base mitral valve. Surgical management valve dysfunction with severe remains technically demanding and, to date, preferred approach still standard full sternotomy. We aimed analyze report our experience surgery addressing via minimally invasive through right mini-thoracotomy. Data patients disease underlying undergoing from 2018 2022 were prospectively collected retrospectively analyzed. The severity was categorized an angio-computerized tomography scan analysis as mild, moderate or according calcium thickness, distribution, trigone leaflet involvement using Annular Calcification Computerized Tomography-score. During study period, 27 associated enrolled. most common etiology advanced Barlow’s disease, which encountered in 18 cases (67%). replacement performed 21 (78%). No intraoperative death, atrioventricular disruption, circumflex coronary artery injury occurred. Conversion sternotomy necessary single case. Residual periprosthetic leak requiring early reoperation permanent heart block mandating pacemaker implantation reported one three patients, respectively. stroke reported. Two died, accounting for 7.4% perioperative mortality. At median follow-up 9 months, patient had residual regurgitation, whereas two required short-term prosthetic (re)replacement. Minimally mini-thoracotomy should be considered effective indicated also mild-to-severe calcification. Routine during work-up mandatory step stratify anatomical extension