[Minimally Invasive Cardiac Surgery with Lower Partial Sternotomy for Combined Valve Disease;Report of a Case].

Combined valve surgery is usually performed with standard sternotomy although the efficacy and safety of single valve surgery with partial sternotomy has been established. We report a successful case of triple valve surgery with lower partial sternotomy. A 69-year-old woman underwent aortic valve replacement, mitral and tricuspid valve repair via lower partial sternotomy for moderate aortic and mitral valve regurgitation as well as severe tricuspid valve regurgitation. The operation was successfully performed with enough surgical field, without using any specific technical devises for minimally invasive cardiac surgery or blood transfusion. The ascending aorta, the superior vena cava and the right femoral vein were cannulated for cardiopulmonary bypass. The procedure was completed as in a conventional approach, except for a small incision for the femoral vein. This approach has several advantages;less trauma, less pain, earlier recovery, and better cosmetic outcomes. Triple valve surgery can be completed using lower partial sternotomy with benefits.