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Compared to conventional full sternotomy (FS) approaches, minimally invasive mitral valve surgery (MIMVS) offers improved cosmesis, decreased pain and bleeding, and faster recovery, without compromising repair or survival rates. However, little is known about outcomes in patients with pulmonary hypertension (PH), an independent risk factor for morbidity and mortality. Retrospective review was performed between 2002 and 2019 for all adult patients undergoing isolated mitral valve (MV) surgery. Patients with PH (mean pulmonary artery p