{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T05:17:16Z","timestamp":1755839836270,"version":"3.41.2"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Minimally invasive mitral surgery is increasingly preferred due to reduced trauma and faster recovery. However, its technical complexity is exacerbated in patients with anatomical anomalies like scoliosis, affecting up to 8.3% of the elderly population. Severe scoliosis causes significant thoracic distortion and alters the positioning of cardiovascular structures, complicating access, visualization, and instrumentation. These factors make minimally invasive mitral valve replacement more complex, as this approach relies on optimal exposure of the mitral valve through a limited incision. We present the case of a 71-year-old female with severe scoliosis undergoing minimally invasive mitral valve replacement with a mechanical prosthesis and septal myectomy. Access was achieved via a 5\u00a0cm right mini-thoracotomy in the second intercostal space. This case report discusses the surgical challenges encountered and the unique considerations and adjustments required in performing cardiac surgery in patients with altered thoracic anatomy, and the importance of preoperative assessment and intraoperative flexibility.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf369","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T18:07:52Z","timestamp":1749146872000},"source":"Crossref","is-referenced-by-count":2,"title":["Navigating anatomical challenges of minimally invasive mitral valve replacement in a patient with severe scoliosis"],"prefix":"10.1093","volume":"2025","author":[{"given":"Henri","family":"Bartolozzi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Galway , Newcastle Rd, Galway , H91YR71,","place":["Ireland"]},{"name":"Faculty of Medicine, Trakia University , Armeyska St 11, Stara Zagora , 6000,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Bartolozzi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Trakia University , Armeyska St 11, Stara Zagora , 6000,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darragh","family":"Rice","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Galway , Newcastle Rd, Galway , H91YR71,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronan J","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Galway , Newcastle Rd, Galway , H91YR71,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Glauber","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Galway , Newcastle Rd, Galway , H91YR71,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"2025060514074721300_ref1","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1097\/01.brs.0000160842.21053.63","article-title":"Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population","volume":"30","author":"Schwab","year":"2005","journal-title":"Spine"},{"key":"2025060514074721300_ref2","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1093\/ije\/16.4.537","article-title":"Prevalence rates for scoliosis in US adults: results from the first National Health and Nutrition Examination Survey","volume":"16","author":"Carter","year":"1987","journal-title":"Int J Epidemiol"},{"key":"2025060514074721300_ref3","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1016\/S0140-6736(94)90562-2","article-title":"Idiopathic 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outcomes","volume":"18","author":"Ramlawi","year":"2021","journal-title":"Cardiothoracic J"}],"container-title":["Journal of Surgical Case 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