2.2 Surgical Procedure
Standard median sternotomy was performed. Cardiopulmonary bypass was established via cannulation of the ascending aorta, superior vena cava, and inferior vena cava. Antegrade and retrograde cold blood cardioplegia were administered intermittently. The mitral valve was approached via a right-sided left atrial (LA) incision. After resecting the anterior leaflet of the mitral valve, the diameter of the mitral annulus was measured using sizers provided by the manufacturers. The implanted valves included St Jude Medical Epic (St Jude Medical Inc., St Paul, MN, USA) in 72 (56.3%), Magna Mitral (Edwards Lifescience, Irvine, CA, USA) in 35 (27.3%), and Mosaic Mitral (Medtronic, Minneapolis, MN, USA) in 21 patients (16.4%). Prosthesis selection was performed at the discretion of the surgeon.