Small Right Vertical Infra-Axillary Incision for Minimally Invasive Port-Access Cardiac Surgery: A Moving Window Method

Port-access cardiac surgery has been developed to minimize skin incision
and improve cosmetic outcomes. Using this method, a skin incision is
generally made just above where the thoracotomy will be placed,
horizontally along the intercostal space at the anterolateral submammary
position. However, this type of incision can affect the frontal view
and shape of the breast. Here, we report our experience with minimally
invasive cardiac surgery using a port-access approach via a small
vertical right infra-axillary incision and a moving window method.
Twenty patients underwent surgical procedures with this approach from
December 2010 to January 2012. Thirteen patients underwent mitral
valvuloplasty, four mitral valve replacement, one mitral and tricuspid
valve replacement and atrial septal defect closure and two atrial septal
defect closure. All surgical procedures were completed using this
minimally invasive method. All patients had an uneventful recovery and
indicated that they were satisfied with the cosmetic results during the
follow-up. Our experience suggests that this technique can effectively
minimize skin incision and improve cosmetic outcomes.