Conventional open-heart surgery is associated with significant morbidity [1]. Today, a minimally invasive approach to mitral valve replacement offers a much safer option for patients requiring a smaller incision and no bone breaks. This approach results in reduced pain, shorter hospital stays, reduced risk of infection, and less scarring [2]. With this new approach came a small wave of innovative surgical instruments catered toward a limited workspace including the Heartport® retractor system [3]. Minimally Invasive Mitral Valve Surgery (MIMVS) has progressed since its inception in the mid 1990's, but the instrumentation has yet to catch up.

MIMVS begins with a 2–3 inch incision on the right chest to act as the access point to the heart throughout the surgery [2]. The incision is represented by the red line on the body outline in Fig. 1. The ribs are separated slightly...

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