Key result
While microinvasive beating heart mitral valve repair reduces surgical trauma, current evidence indicates it is associated with higher rates of early repair failure and recurrent mitral regurgitation compared to conventional surgery.
Why the study?
New microinvasive techniques allow mitral valve repair through small incisions avoiding cardio-pulmonary bypass, but conceptually differ significantly from surgical repair and their ability to reproduce surgical results remains questionable.
Does microinvasive mitral valve surgery reproduce the results of standard surgical mitral valve repair in patients with degenerative mitral valve disease?
Does microinvasive mitral valve surgery reproduce the results of standard surgical mitral valve repair in patients with degenerative mitral valve disease?
This review highlights the conceptual differences between new microinvasive mitral valve techniques and standard surgical repair, questioning their comparative efficacy and durability.
Does not support routine adoption of microinvasive repair; leaves open whether RCTs can establish durable equivalence to conventional surgery.
Surgical mitral valve repair, performed either through median sternotomy or minimal invasive approach, presents the gold standard treatment for degenerative mitral valve disease. In dedicated centres, high repair and low complication rates have been established with excellent valve repair durability. Recently, new techniques have been introduced, that allow mitral valve repair to be performed through small surgical incisions and while avoiding cardio-pulmonary bypass. These new techniques, however, conceptually differ significantly when compared to surgical repair and it remains questionable whether they are capable of reproducing the results of surgical treatment.
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Tomšič et al. (2023) conducted a review in Degenerative mitral valve disease. Microinvasive beating heart mitral valve repair vs. Conventional surgical mitral valve repair was evaluated. While microinvasive beating heart mitral valve repair reduces surgical trauma, current evidence indicates it is associated with higher rates of early repair failure and recurrent mitral regurgitation compared to conventional surgery.
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