Initial experience of minimally invasive triple valve surgery in a developing country

Figure 1 Intraoperative photographs. A: Exposure of the mitral valve via intra-atrial septal approach through right atriotomy; B: Exposure of the aortic valve via transverse aortotomy; C: Tricuspid valve repair using a pericardial strip (black arrow), illustrating pericardial strip annuloplasty technique for functional tricuspid regurgitation; D: Right mini-thoracotomy incision site, highlighting the minimally invasive surgical access.

Figure 2 Echocardiographic findings. A-C: Preoperative echocardiogram demonstrating severe multivalvular disease with restricted leaflet motion and regurgitation; D-F: Postoperative echocardiogram showing well-functioning prosthetic valves and a competent tricuspid valve, confirming successful surgical outcome.