Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Jun;35(6):1209-1219.
doi: 10.1111/jocs.14558. Epub 2020 Apr 19.

Comparison of outcomes between minimally invasive and median sternotomy for double and triple valve surgery: A meta-analysis

Haya Mohammed  1 , M Yousuf Salmasi  2 , Massimo Caputo  3 , Gianni D Angelini  3 , Hunaid A Vohra  3
Affiliations
Meta-Analysis

Comparison of outcomes between minimally invasive and median sternotomy for double and triple valve surgery: A meta-analysis

Haya Mohammed et al. J Card Surg. 2020 Jun.

Abstract

Background: Limited data exists demonstrating the efficacy of minimally invasive surgery (MIS) compared to median sternotomy (MS) for multiple valvular disease (MVD). This systematic review and meta-analysis aims to compare operative and peri-operative outcomes of MIS vs MS in MVD.

Methods: PubMed, Ovid, and Embase were searched from inception until August 2019 for randomized and observational studies comparing MIS and MS in patients with MVD. Clinical outcomes of intra- and postoperative times, reoperation for bleeding and surgical site infection were evaluated.

Results: Five observational studies comparing 340 MIS vs 414 MS patients were eligible for qualitative and quantitative review. The quality of evidence assessed using the Newcastle-Ottawa scale was good for all included studies. Meta-analysis demonstrated increased cardiopulmonary bypass time for MIS patients (weighted mean difference [WMD], 0.487; 95% confidence interval [CI], 0.365-0.608; P < .0001). Similarly, aortic cross-clamp time was longer in patients undergoing MIS (WMD, 0.632; 95% CI, 0.509-0.755; P < .0001). No differences were found in operative mortality, reoperation for bleeding, surgical site infection, or hospital stay.

Conclusions: MIS for MVD have similar short-term outcomes compared to MS. This adds value to the use of minimally invasive methods for multivalvular surgery, despite conferring longer operative times. However, the paucity in literature and learning curve associated with MIS warrants further evidence, ideally randomized control trials, to support these findings.

Keywords: double valve; meta-analysis; minimally invasive; triple valve.

PubMed Disclaimer

References

REFERENCES

    1. Mack MJ. Minimally invasive cardiac surgery. Surg Endosc Other Intervent Techn. 2006;20(2):S488-S492.
    1. Vohra HA, Ahmed EM, Meyer A, Kempfert J. Knowledge transfer and quality control in minimally invasive aortic valve replacement. Eur J Cardiothorac Surg. 2018;53(suppl 2):ii9-ii13.
    1. Vola M, Fuzellier J-F. Extending minimally invasive approaches to concomitant aortic and mitral valve surgery: are we ready? Eur J Cardiothorac Surg. 2016;50:1206-1207.
    1. Goldstone AB, Woo YJ, eds. Minimally invasive surgical treatment of valvular heart disease. Seminars in thoracic and cardiovascular surgery. Elsevier; 2014.
    1. Young CP, Sinha S, Vohra HA. Outcomes of minimally invasive aortic valve replacement surgery. Eur J Cardiothorac Surg. 2018;53(suppl 2):ii19-ii23.

LinkOut - more resources