{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:50:57Z","timestamp":1777737057728,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations&amp;#65533;(Phila)"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Minimally invasive combined mitral and aortic valve surgery is still uncommon. We report our experience performing multiple valve procedures through a right-sided minithoracotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We present an observational case series with a retrospective analysis of 38 patients who underwent double valve surgery through right anterior thoracotomy from November 2013 to November 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The median age of our population was 72 years, and 61% were female patients. The median EuroSCORE II was 2.27. Three patients (7.9%) had redo operations. The median cardiopulmonary bypass (CPB) and cross-clamp times were 98 and 85 min, respectively. No conversion to full sternotomy was necessary. In-hospital mortality was 2.6% (1 patient); the patient died of septic shock and consequent multiorgan failure. Of the patients, 53% required transfusions with packed blood cells. Postoperative atrial fibrillation was observed in 12 patients (32%), and 2 patients (5.2%) required pacemaker implantation due to third-degree atrioventricular block. Also, 1 stroke (2.6%) and 1 rethoracotomy for bleeding were observed. The median ventilation time was 10 h. The median intensive care unit and postoperative length of stay were 2 days and 7.5 days, respectively. Survival at 1, 3, 5, and 10 years was 93.8%, 86.3%, 86.3%, and 77.2%, respectively, with a median follow-up time of 6.5 years. Freedom from reintervention at 1, 3, 5, and 10 years was 96.8%, 89.5%, 85.0%, and 69.5%, respectively, with a median follow-up time of 5.7 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In our experience, a minimally invasive approach for combined aortic and mitral valve surgery is safe and feasible, with acceptable CPB and cross-clamp times and good outcomes. Therefore, it can be an attractive option for patients with double valve diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845251314025","type":"journal-article","created":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T01:51:16Z","timestamp":1739584276000},"page":"73-79","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Combined Mitral and Aortic Valve Surgery Through a Right Minithoracotomy: A Single-Center Experience"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1396-4330","authenticated-orcid":false,"given":"Mariafrancesca","family":"Fiorentino","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-8700","authenticated-orcid":false,"given":"Elisa","family":"Mikus","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Tripodi","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Sangiorgi","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Calvi","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Tenti","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Costantino","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Savini","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Cardio-Vascular Surgery Department, Maria Cecilia Hospital, GVM Care &amp; Research, Cotignola, Italy"},{"name":"Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-015-0390-y"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.05.015"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.11.041"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.7800"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac167"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.07.018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.03.47"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.15267"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14997"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00201-X"},{"key":"e_1_3_2_12_2","first-page":"693","article-title":"Right anterior mini-thoracotomy: a \u2018new gold standard\u2019 for aortic valve replacement?","volume":"24","author":"Mikus E","year":"2015","unstructured":"Mikus E, Calvi S, Panzavolta M, et al. Right anterior mini-thoracotomy: a \u2018new gold standard\u2019 for aortic valve replacement? J Heart Valve Dis 2015; 24: 693\u2013698.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.09.046"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199710000-00003"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-023-02229-x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivx212"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2020.09.936"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"e_1_3_2_19_2","first-page":"59","article-title":"Central versus femoral cannulation during minimally invasive aortic valve replacement","volume":"4","author":"Murzi M","year":"2015","unstructured":"Murzi M, Glauber M. Central versus femoral cannulation during minimally invasive aortic valve replacement. Ann Cardiothorac Surg 2015; 4: 59\u201361.","journal-title":"Ann Cardiothorac Surg"},{"key":"e_1_3_2_20_2","article-title":"Outcomes of minimally invasive double valve surgery","volume":"9","author":"Santana O","year":"2017","unstructured":"Santana O, Xydas S, Williams RF, et al. Outcomes of minimally invasive double valve surgery. J Thorac Dis 2017; 9(suppl 7): S602\u2013S606.","journal-title":"J Thorac Dis"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.18-186"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14558"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.06.060"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2008.08.004"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845251314025","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845251314025","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845251314025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:18:22Z","timestamp":1777461502000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845251314025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1177\/15569845251314025"],"URL":"https:\/\/doi.org\/10.1177\/15569845251314025","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}