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Figure 1 Atrial incisions for mitral valve surgery. (A) The standard right lateral left atriotomy involves an incision in the left atrium (LA) anterior to the right superior and inferior pulmonary veins (RSPV, RIPV). (B) A modification of this approach is dissection in the interatrial groove, with an incision posterior to the fossa ovalis. (C₁ and C₂) The superior trans-septal approach involves an atriotomy in the lateral wall of the right atrium (RA), which is extended over the superior RA, the septum and the dome of the LA (C₁). Cannulae are indicated in the inferior vena cava, superior vena cava or the right atrial appendage, as well as for retrograde cardioplegia via the coronary sinus.