Why the study?
Does port-access video-assisted mitral valve surgery improve outcomes compared to the traditional approach in patients requiring mitral valve surgery?
Does port-access video-assisted mitral valve surgery improve outcomes compared to the traditional approach in patients requiring mitral valve surgery?
Port-access video-assisted mitral valve surgery is a safe and effective alternative to traditional approaches, especially in high-risk or redo scenarios.
May support port-access mitral surgery in redo and elderly patients; leaves open randomized comparisons to sternotomy.
The aim of this review is to focus the attention on the "state of the art" of port-access and video-assisted mitral valve surgery appraising the results compared to the traditional approach, describing different technical strategies and analyzing how to avoid and manage its related complications concomitantly elucidating which procedure is associated with the most favorable risk-benefit and cost-benefit profile. Our default strategy is to use the minimally invasive approach combining video-assisted right mini-thoracotomy with endo-cardiopulmonary bypass and endo-aortic balloon occlusion (EBO) whenever possible. This choice is supported by the evidence that, after an initial learning curve, it is a safe and effective approach in terms of short- and long-term results, mainly for redo operations and even for elderly patients with moderately elevated peri-operative risk.
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Chirichilli et al. (2013) studied this question.
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