Key result
Minimally invasive mitral valve surgery via partial upper sternotomy achieves ~81% 10-year survival.
Why the study?
Minimally invasive mitral valve surgery via partial upper sternotomy has emerged as an alternative to conventional sternotomy aiming to decrease surgical trauma, but experience regarding short- and long-term outcomes is limited.
Cohort (n=419)
No
Minimally invasive mitral valve surgery via partial upper sternotomy demonstrates good early and late survival and freedom from reoperation, offering a viable alternative for patients unsuitable for minithoracotomy.
May support partial upper sternotomy in select mitral cases; leaves open randomized comparisons to other approaches.
Background: Minimally invasive mitral valve (MV) surgery has emerged as an alternative to conventional sternotomy aiming to decrease surgical trauma. The aim of the study was to describe our experience with minimally invasive MV surgery through partial upper sternotomy (PUS) regarding short- and long-term outcomes. Methods: From January 2004 through March 2014, 419 patients with a median age of 58.9 years (interquartile range 18.7; 31.7% females) underwent isolated primary MV surgery using PUS. Myxomatous degenerative MV disease was the predominant pathology (77%). The patients’ mean EuroSCORE II risk profile was 3.9 ± 3.6%. Results: Mitral valve repair was performed in 384 patients (91.6%) and replacement in 35 patients (8.4%). Thirty-day mortality was 3.1%. In total, 29 (6.9%) deaths occurred during the follow-up. The overall estimated survival at 1, 5, and 10 years was 93.1 ± 1.3%, 87.1 ± 1.9%, and 81.1 ± 3.4%. Reoperation was necessary in 14 (3.3%) patients. The overall freedom from MV reoperation at 1, 5, and 10 years was 98.2 ± 0.7%, 96.1 ± 1.2%, and 86.7 ± 6.7% and the overall freedom from recurrent MV regurgitation > grade 2 in repaired valves at 1, 5, and 10 years was 98.8 ± 0.6%, 98.8 ± 0.6%, and 94.6 ± 3.3%. Conclusions: Minimally invasive MV surgery via PUS can be performed with particularly good early and late results. Thus, the PUS approach with the use of standard surgical instruments and cannulation techniques can be a valuable option for the MV surgery either in patients contraindicated or not suitable to minithoracotomy.
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Radwan et al. (2021) conducted a cohort in Mitral valve disease (n=419). Minimally invasive mitral valve surgery via partial upper sternotomy (PUS) was evaluated on Short- and long-term outcomes including mortality, survival, and freedom from reoperation. Minimally invasive mitral valve surgery via partial upper sternotomy demonstrated good outcomes, with a 30-day mortality of 3.1% and an estimated 10-year survival of 81.1%.
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