Who Should Not Have a Mini-Mitral Procedure?

Excellent presentation! Dr. Carrel: Congratulations on your good results regarding your high repair rate and low conversion rate. 1. With respect to patients with previous cardiac surgery, in our department we performed the MICS technique in patients with previous cardiac surgery and we have had good results (only patients with prior sternotomy). In other centers they have also had favorable results, just like Seeburger J and Michael Borger. [Seeburger J, Borger MA, Falk V, Passage J, Walther T, Doll N, Mohr FW. Minimally invasive mitral valve surgery after previous sternotomy: experience in 181 patients. Ann Thorac Surg. 2009;67:709–14.]. Despite the evidence: Do you think that patients with previous cardiac surgery should be considered as a relative/absolute contraindication? 2. What is your opinion about patients with active mitral valve endocarditis and the MICS technique?. 3. About MICS´s future… Could it be that today's surgeons do not want to adopt MICS techniques just because they are presumably more complex?. Thank you very much!