Remote access perfusion for minimally invasive mitral surgery is commonly achieved by femorofemoral bypass. We describe the use of the carotid artery as an inflow in 2 patients with severe calcifications of the abdominal aorta and the iliac arteries who underwent minimally invasive mitral and tricuspid valve repair. The easy and fast access to the vessel and the lack of interference with the transthoracic clamp and scope are the major advantages of carotid artery compared with other alternatives such as the axillary artery. We propose this technique in candidates for minimally invasive valve procedures with contraindications to femoral perfusion.
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