Successful Minimally Invasive Mitral Valve Repair and Maze Procedure in a Patient With Myotonic Dystrophy.

Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystemic disorder caused by unstable nucleotide repeat duplications. Management of general anesthesia is challenging due to the high risk of myotonia and postoperative respiratory complications. While few cases of cardiac surgery in patients with DM1 have been reported, there is no reported case of utilizing minimally invasive cardiac surgery (MICS), which avoids sternotomy for preservation of respiratory function in these patients. We report a successful case of MICS mitral valve repair (MVr) and a maze procedure in a patient with DM1. To minimize postoperative respiratory depression, a paravertebral block was also employed, which successfully reduced opioid dosage. In patients with myotonic dystrophy, an MICS approach combined with cautious perioperative pharmacological management and peripheral nerve blocks may effectively mitigate the risk of postoperative respiratory complications.