Introduction
The use of minimally invasive or transcatheter interventions rather than standard full sternotomy operations to treat heart valve disease is increasing. Management of tricuspid valve disease is no different: minimally invasive techniques are more frequently utilized to perform standardized surgical operations. Surgery through right mini-thoracotomy approach has established itself as an optimal option to treat pathologies affecting atrio-ventricular valves [1] [2]. Experienced and specifically trained surgeons can achieve excellent results as those obtained with standard sternotomy, with many studies reporting better pain control, faster recovery and a shorter hospital stay as compared to conventional surgery [3]. Excellent results have also been reported for tricuspid valve operations performed with a minimally invasive approach [4] [5] [6], debate however is still open regarding venous drainage management during cardiopulmonary bypass (CPB) and wheatear or not superior and inferior vena cava should be occluded during opening of the right atrium to avoid air entrance in the venous line. The aim of the present study is to report operative outcomes and mid-term follow-up results of minimally invasive tricuspid valve surgery performed without caval occlusion.