The most common approach for surgeons to reach the heart is a median sternotomy (vertically cutting the breastbone), but other incisions can be employed, such as a left or right thoracotomy. After the heart is exposed, the patient is put on a cardiopulmonary bypass machine, also known as a heart–lung machine. This machine breathes for the patient and pumps their blood around their body – bypassing the heart – while the surgeon replaces the heart<unk> . Next, an aortic clamp is placed on the aorta, and the heart is stopped (cardioplegia). Depending on the pathology of the mitral<unk>  and surgeon's preference, various approaches can be used to access the mitral<unk> . The interatrial groove approach involves incising the left atrium posterior to the interatrial groove. The transatrial oblique approach is utilized when the left atrium is small. In this approach, the right atrium is opened and another incision is made at the interatrial septum. The<unk>  is excised 4–5 mm from the annulus, leaving intact the attached chordae unless they are calcified or otherwise diseased. The<unk>  is replaced by a mechanical or bioprosthetic<unk> . The<unk> <unk>  is sewn into the annulus with interrupted or horizontal mattress sutures with the pledgets on the atrial side. The atrial walls are closed, taking care not to trap air within the chambers of the heart. The heart is restarted, and the patient is taken off the heart–lung machine.
Mitral valve replacement
Mitral valve repair
Mitral valve annuloplasty
Aortic valve repair
Heart valve repair
Aortic valvuloplasty
Aortic valve replacement
Percutaneous aortic valve replacement