# Dual-Camera Port Setup Strategies for Totally Endoscopic Aortic and Mitral Valve Surgery

## TL;DR

This paper describes a new surgical technique using two camera ports for minimally invasive heart valve surgery in a high-risk patient.

## Contribution

The novel use of a dual-camera port setup enables safer and more effective totally endoscopic double-valve surgery.

## Key findings

- A dual-camera port setup improved visualization and maneuverability during combined aortic and mitral valve surgery.
- The patient recovered well and was discharged on postoperative day seven.
- The approach is a minimally invasive alternative for complex cardiac cases.

## Abstract

Endoscopic cardiac surgery offers favorable early outcomes because of its minimally invasive nature. However, its application in combined aortic and mitral valve procedures remains limited owing to differences in optimal visualization angles and the technical complexity of the procedure. A septuagenarian woman (body surface area 1.2 m2) with severe mitral stenosis, atrial fibrillation, and aortic valve papillary fibroelastoma, who was wheelchair-bound, underwent endoscopic double-valve surgery. Preoperative computed tomography revealed that a single camera port did not provide optimal visualization. Therefore, we employed a dual-camera port setup to facilitate safe mitral valve replacement and aortic tumor resection. The patient recovered uneventfully and was discharged on postoperative day seven. The dual-camera port approach improves visualization and maneuverability in totally endoscopic double-valve surgery, offering a minimally invasive and effective alternative for complex cases, particularly in high-risk patients.