Video and Robotic-Assisted Minimally Invasive Mitral Valve Surgery: A Comparison of the Port-access and Transthoracic Clamp Techniques Hermann Reichenspurner,

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Video and Robotic-Assisted Minimally Invasive Mitral Valve Surgery: A Comparison of the Port-access and Transthoracic Clamp Techniques Hermann Reichenspurner, MD, PhD, Christian Detter, MD, Tobias Deuse, MD, Dieter H. Boehm, MD, PhD, Hendrik Treede, MD, Bruno Reichart, MD The Annals of Thoracic Surgery Volume 79, Issue 2, Pages 485-490 (February 2005) DOI: 10.1016/j.athoracsur.2004.06.120 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Intraoperative setup for the MICRO technique. The placement of the transthoracic clamp is facilitated by the two or three-dimensional image provided by the robotically guided endoscope (Vista Cardiothoracic Systems, Inc, Westborough, MA). The Annals of Thoracic Surgery 2005 79, 485-490DOI: (10.1016/j.athoracsur.2004.06.120) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The transthoracic aortic clamp. The Annals of Thoracic Surgery 2005 79, 485-490DOI: (10.1016/j.athoracsur.2004.06.120) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 For the MICRO technique, the ascending aorta is directly clamped by the transthoracic aortic clamp and antegrade cardioplegia is applied by a needle-vent catheter. The Annals of Thoracic Surgery 2005 79, 485-490DOI: (10.1016/j.athoracsur.2004.06.120) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Minimally invasive mitral valve surgery is performed under video and robotic assistance through a right anterolateral minithoracotomy approach. The Annals of Thoracic Surgery 2005 79, 485-490DOI: (10.1016/j.athoracsur.2004.06.120) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Postoperative cosmetic result after minimally invasive mitral valve surgery. The Annals of Thoracic Surgery 2005 79, 485-490DOI: (10.1016/j.athoracsur.2004.06.120) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions