There are a variety of approaches to valve surgeries - and depends on which valve (aortic, mitral, tricupsid, pulmonic), the reason for the valve surgery (endocarditis, calcified, stenosed, regurgitatnt, peforated, etc), and the patient history and presence/absence of other co-morbidities. A valve "repair" such as a mitral valve repair can often times be done via minimally invasive techniques, but again, is usually done if the diseased native valve is amenable to just a repair (rather than a replacement) and if there are no other reasons to proceed through a sternotomy (no bypass surgery needed, no other valves affected, etc). Additionally, there are also percutaneous options, such as for the aortic valve (transfemoral or transapical aortic valve replacement) which are done for select patients who have a stenosed aortic valve and are not candidates for the traditional open aortic valve surgery.
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