Cirurgia valvar mitral e da comunica？？o interatrial: abordagem minimamente invasiva ou por esternotomia

background: to decrease the surgical trauma in heart procedures, minimally invasive (mi) techniques were alternatively introduced. objective: to compare mi surgical access with median sternotomy (ms) for the treatment of mitral valve (mv) disease and atrial septal defect (asd). methods: forty patients underwent surgery for correction of mv disease or asd. patients were divided into group a (ga) (n=20), access by right minithoracotomy and video-assistance; and group b (gb) (n=20), access by full ms. aortic cross-clamp and cardiopulmonary bypass time, intensive care unit (icu) time, hospital stay and morbidity were compared in this prospective study . results: fifteen patients were submitted to mv procedures and five to asd corrections in each group. there were 9 mitral replacements (7 bioprostetic and 2 mechanical) and 6 repairs in ga, and 10 (all bioprostetic) and five in gb. the mean aortic cross-clamp and cardiopulmonary bypass time, in minutes, were 65.1 ± 29.3 in ga and 50.2 ± 21.4 in gb (p=0.074); and 91.8±35 in ga and 63.7±27.3 in gb ( p=0.008). the mean icu time, in hours, were 51.7 ± 16.3 in ga and 55.8±17.5 in gb (p=0.45). the in hospital stay, in days, were 5.2 ± 1 in ga and 6.4±1.5 in gb (p=0.009). conclusion: mi access for correction of the mv disease and asd implicated in a longer cardiopulmonary bypass time for finalization of the main procedure, nevertheless it didn′t affect patient's recuperation. mi treated patients were discharged earlier than sternotomy treated patients.