Abstract OBJECTIVES The present study compared the clinical outcome between endo-aortic balloon occlusion and transthoracic clamping in patients undergoing minimally invasive mitral valve surgery METHODS All patients from the Mini-Mitral International Registry undergoing minimally invasive mitral valve surgery were primarily considered for study inclusion. One-to-one nearest neighbour propensity score matching considering clinically relevant baseline covariates. The matched cohort was investigated regarding the clinical outcome between endo-aortic balloon occlusion and transthoracic clamping according to the end-point definitions of the Mitral Valve Academic Research Consortium. RESULTS From 2015 to 2021 a total of 6884 patients were primarily included in the study. Propensity score matching resulted in a population of 733 matched pairs. Patients treated with endo-aortic balloon occlusion showed significantly lower rates of conversion to sternotomy (13 (1.8%) vs 34 (4. 6%); p = 0.001), longer cardiopulmonary bypass time (124 min 105–147 vs 120 min 90–148; p = 0.001) and a longer intubation time (11.8 h 7.9–22.2 vs 10.8 h 6.4–20.0; p 0.001). No statistically significant differences were observed regarding postoperative mortality, stroke, bleeding requiring revision, vascular complications, intensive care unit stay or hospital length of stay. CONCLUSIONS In patients undergoing minimally invasive mitral valve surgery, endo-aortic balloon occlusion and transthoracic clamping are excellent options for aortic clamping. endo-aortic balloon occlusion showed benefits over transthoracic clamping with lower rates of conversion to full sternotomy.
Kofler et al. (Tue,) studied this question.