When doing a Minimally invasive AVR/MVR, Exposure of the MV may be challenging. One obstacle is the femoral venous cannula which lies in the SVC. When placing the atrial lift retractor, exposure of the mitral valve is obstructed. The solution is to place a sump suction in the SVC via a purse string suture after withdrawing the femoral venous cannula into the IVC. This allows additional upward retraction of the atrial septum and improves MV exposure. Always keep in mind that the MV is visualized on a 45 degree downward angle.
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