A randomized controlled trial (PAMI trial) on our new trend periareolar minimally invasive (PAMI) technique versus inframammary approach for minimally invasive cardiac surgery

The Cardiothoracic Surgeon

Table 5 Pros and cons of 3rd and 4th space according to our surgical experience

	4th space	3rd space
Termed in relation to our experience	Space of practicability	Space of safety or Sense of security
Access to aorta	Limited access	Good access
Access to SVC	Limited access	Good access
Displacement of aorta	Cannot handle	Can handle by putting gauze behind it to pull it in front
Mitral valve	Directly in front	Must stand in a tilted position (30°)