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Objective To summarize the efficiency and safety of the video-assisted thoracoscopic surgery for mitral valvuloplasty.Methods From Jan.2010 to Feb.2013, 34 cases performed video-assisted thoracoscopic mitral valvuloplasty operation including 25 valvular degeneration cases, 4 congenital mitral valve disease cases,4 infective endocarditis cases and 1 rheumatic case respectively.Preoperative echocardiography showed moderate to severe mitral valve insufficiency in 11 cases, severe insufficiency in 23 cases.The establishment of cardiopulmonary bypass (CPB) were accessed from right femoral artery and vein cannula or superior venae cava carmula in all cases.Antegrade perfusion was applied in all patients for myocardial protection.The operation was accomplished through one small right thoracotomy incision (4-5cm) and two holes with the thoracoscope.Results There was no death.The ventilation duration time is shorter, postoperative chest drainage volume is less, postoperative hospitalization time is shorte and blood transfusion is fewer compared with the traditional thoracotomy group,.No regurgitation (< 1.0ml/cm 2) in 19 cases, mild regurgitation (1.0-4.0cm 2) in 12 cases, moderate mitral regurgitation (4.0-8.0cm 2) in2 cases showed by the ultrasound after the operation.The follow-up was 3~18 months, showed the left atrial diameter and left ventricular end-diastolic diameter reduced significantly compared with preoperative parameters.Conlusions Video-assited thoracoscopic mitral valvuloplasty operation is an effective clinical metho with less invasive and beautiful incision..