Key result
Mitral valvuloplasty via a totally thoracoscopic approach resulted in a lower blood transfusion rate compared to median sternotomy (5.3% vs. 20.9%, p<0.05).
Why the study?
Disagreement exists regarding methods for repair of the mitral valve.
Does a totally thoracoscopic minimally invasive approach improve early outcomes compared to median sternotomy in patients undergoing mitral valvuloplasty?
Cohort (n=507)
No
Does a totally thoracoscopic minimally invasive approach improve early outcomes compared to median sternotomy in patients undergoing mitral valvuloplasty?
Absolute Event Rate: 5.3% vs 20.9%
p-value: p=<0.05
Minimally invasive totally thoracoscopic mitral valvuloplasty improves early postoperative outcomes, including reduced blood transfusions and shorter hospital stays, compared to traditional median sternotomy.
Minimally invasive thoracoscopic mitral valvuloplasty was associated with fewer transfusions and shorter stays; leaves open whether benefits persist in randomized trials.
Background Disagreement exists regarding methods for repair of the mitral valve. We compared early outcomes of mitral valvuloplasty by a minimally invasive technique and by a median sternotomy. Methods The data of 507 patients (mean age 47.9 ± 15.2 years) undergoing mitral valvuloplasty from January 2015 to June 2018 were analyzed retrospectively. In the study group ( n = 225), mitral valvuloplasty via a totally thoracoscopic approach was performed by a single surgeon. In the control group ( n = 282), mitral valvuloplasty via the traditional median sternotomy was carried out by other cardiac surgeons in our hospital. Clinical data, surgical results, and follow-up findings in the two groups were comparatively analyzed. Results In the study group, the blood transfusion rate (5.3% vs. 20.9%, p < 0.05) and incidences of poor wound healing (0 vs. 5.3%, p < 0.05) and respiratory tract infection (4.4% vs. 16.3%, p < 0.05) were lower, and postoperative hospitalization was shorter (5.9 ± 4.0 vs. 10.7 ± 8.4 days, p < 0.05). Within 30 days after surgery, no patient died in the study group while one died in the control group. The duration of follow-up was 12–36 months (mean 22.9 ± 8.8 months). During follow-up, there were 1 and 0 cases of redo surgery and 1 and 3 deaths in the study group and control group, respectively. Conclusion Mitral valvuloplasty via a minimally invasive approach is superior to the traditional median sternotomy in terms of early outcomes, especially when performed by experienced surgeons.
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Huang et al. (2020) conducted a cohort in Mitral valve disease requiring valvuloplasty (n=507). Mitral valvuloplasty via a totally thoracoscopic approach vs. Mitral valvuloplasty via traditional median sternotomy was evaluated on Blood transfusion rate (p=<0.05). Mitral valvuloplasty via a totally thoracoscopic approach resulted in a lower blood transfusion rate compared to median sternotomy (5.3% vs. 20.9%, p<0.05).
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