Anaesthesiologic considerations in the minimally invasive setting

Minimally invasive cardiac surgery of the mitral valve (MIMVS) has become an alternative standard of care in the majority of heart centres dedicated to valve surgery. The minimally invasive approach has gained widespread acceptance from surgeons mainly based on the superior quality of valve visibility and the avoidance of large surgical incisions. The short and mid-term results of the quality of repair and the incidence of perioperative complications are comparable or even superior to the classical open approach even in high-risk patients. From the anaesthesiologic point of view, the minimally invasive approach is more demanding and requires additional knowledge and skills compared to the classical open sternotomy approach. Therefore, a special training program and dedication of team members is required to perform these procedures with comparable low complication rates. In this review, we describe the relevant anaesthesia related topics which are part of the anaesthesia management, pre-, intra- and postoperatively.