Minimally invasive cardiac surgery is commonly used to treat degenerative mitral regurgitation. The totally endoscopic approach has emerged as an attractive alternative procedure especially for young patients and has been described in isolated mitral and aortic valve settings. The totally endoscopic double valve procedure, including mitral and aortic valves, extends this treatment option to a broader patient population. We describe our approach to performing a totally endoscopic concomitant aortic and mitral valve procedure that has overcome unique technical hurdles and has yielded favorable outcomes.
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