MINIMALLY INVASIVE cardiac surgery is becoming increasingly and has advantages, but it involves decreased surgical exposure. The authors report a case in which a minimally invasive approach to the aortic valve precluded manual palpation of the left ventricle during administration of antegrade cardioplegia. Transesophageal echocardiography (TEE) showed maldistribution of cardioplegia, with the solution entering the left ventricle and, subsequently, left atrium, through incompetent aortic and mitral valves.
