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Accessory mitral valve is an uncommon cause of left ventricular outflow tract obstruction in the adult patient. 1 Excisional therapy has traditionally been performed through the proximal aorta by using a median sternotomy. We report the excision of an obstructive accessory mitral leaflet through the left atrium using a right chest endoscopic approach with the da Vinci Robotic System (Intuitive Surgical, Sunnyvale, Calif).

Clinical Summary:
The clinical characteristics of 3 patients with left atrial masses
operated on between September 2003 and May 2004 are presented
in Table 1. No patient had preoperative embolic phenomena.