The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on thoracoscopically assisted mitral valve surgery.


Thoracoscopically assisted mitral valve surgery involves the repair of a defective valve through one or more small incisions between the ribs rather than one large incision through the breastbone (sternum), and using a camera to visualise the procedure. The patient is connected to a heart-lung machine, which temporarily takes over the function of the heart and lungs during the procedure. Robotic assistance can also be used during the procedure.

Coding recommendations

A code from Y74. - Minimal access to thoracic cavity would be used as a supplementary code following a code from Chapter ‘K’ for the primary mitral valve surgery carried out.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.