Conventional versus Minimally Invasive Mitral Valve Replacement in Early and Midterm Outcomes: Comparative Study

Background: There was widespread acceptance of minimally invasive mitral valve surgery. Nonetheless, there is continuing debate regarding its potential to supplant the traditional full sternotomy procedure. Aim of work: This study aimed to compare between the conventional full sternotomy and minimally invasive strategies for mitral valve replacement. Patients and methods: The study enrolled 50 patients, who were evenly divided into two groups: Group A included 25 patients who underwent conventional mitral valve replacement, while group B comprised 25 patients who received minimally invasive mitral valve replacement. All patients underwent thorough preoperative evaluation, including detailed medical history, physical examination, and relevant laboratory and radiological investigations. Intraoperative assessment focused on parameters such as incision length, aortic cross-clamp time, total bypass time, and weaning events. Postoperative evaluation included duration of mechanical ventilation, need for re-exploration due to bleeding, pain assessment and documentation of any complications. Results: No significant differences were observed between the patient groups. The incision length was notably shorter in group B compared to group A. However, cannulation, bypass, and overall operative times were significantly longer in group B. Postoperatively, group B experienced significantly lower ventilation times, shorter ICU and hospital stays, reduced bleeding and lower pain scores. At the 6-month follow-up, both groups demonstrated comparable outcomes, with no significant differences observed in overall recovery or clinical status. Conclusion: Minimally invasive mitral valve surgery demonstrated favorable short- and mid-term outcomes and showed marked improvements in early postoperative measures, including ventilation time, bleeding, pain, and cosmetic satisfaction, compared to conventional mitral valve surgery.