Minimally invasive mitral valve surgery was associated with faster recovery (parameter estimate 12.0; 95% CI 5.7-18.3; P<0.001) and less pain compared to sternotomy.
Cohort (n=94)
Does minimally invasive mitral valve repair improve patient-reported recovery time and pain compared to sternotomy in patients undergoing isolated mitral valve surgery?
Minimally invasive mitral valve repair is associated with faster patient-reported recovery and less pain compared to sternotomy, with similar treatment satisfaction and safety.
Mean Difference: 12 (95% CI 5.7–18.3)
Absolute Event Rate: 61.7% vs 51.7%
p-value: p=<0.001
OBJECTIVES: To compare patient-reported outcome measures of minimally invasive (MI) to sternotomy (ST) mitral valve repair. METHODS: We included all patients undergoing isolated mitral valve surgery via either a right mini-thoracotomy (MI) or ST over a 36-month period. Patients were asked to complete a modified Composite Physical Function questionnaire. Intraoperative and postoperative outcomes, and patient-reported outcome measures were compared between 2 propensity-matched groups (n = 47/group), assessing 3 domains: 'Recovery Time', 'Postoperative Pain' (at day 2 and 1, 3, 6 and 12 weeks) and 'Treatment Satisfaction'. Composite scores for each domain were subsequently constructed and multivariable analysis was used to determine whether surgical approach was associated with domain scores. RESULTS: The response rate was 79%. There was no mortality in either group. In the matched groups, operative times were longer in the MI group (P < 0.001), but postoperative outcomes were similar. Composite scores for Recovery Time ST 51.7 (31.8-62.1) vs MI 61.7 (43.1-73.9), P = 0.03 and Pain ST 65.7 (40.1-83.1) vs MI 79.1 (65.5-89.5), P = 0.02 significantly favoured the MI group. Scores in the Treatment Satisfaction domain were high for both surgical approaches ST 100 (82.5-100) vs MI 100 (95.0-100), P = 0.15. The strongest independent predictor of both faster recovery parameter estimate 12.0 95% confidence interval (CI) 5.7-18.3, P < 0.001 and less pain parameter estimate 7.6 (95% CI 0.7-14.5, P = 0.03) was MI surgery. CONCLUSIONS: MI surgery was associated with faster recovery and less pain; treatment satisfaction and safety profiles were similar.
Whiteley et al. (Mon,) conducted a cohort in isolated mitral valve surgery (n=94). Minimally invasive right mini-thoracotomy vs. Sternotomy was evaluated on Composite score for Recovery Time (parameter estimate 12.0, 95% CI 5.7-18.3, p=<0.001). Minimally invasive mitral valve surgery was associated with faster recovery (parameter estimate 12.0; 95% CI 5.7-18.3; P<0.001) and less pain compared to sternotomy.