Mitral regurgitation in a patient with Noonan syndrome: re-do mitral valve repair via mini-thoracotomy

In this article, we present a 38-year-old male case with Noonan syndrome who underwent repair for an atrial septal defect (ASD) at the age of 14. Severe mitral regurgitation, mild tricuspid regurgitation, and residual ASD were detected on echocardiography. As repeated sternotomy was hindered by a severely dilated cardiac chamber with retrosternal adhesion and a suprasternally located aortic arch, we performed a right anterolateral thoracotomy approach with peripheral cannulation. This minimally invasive approach may be an optimal alternative for early recovery in patients with these characteristics.