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
. 2020 Oct;7(2):e001393.
doi: 10.1136/openhrt-2020-001393.

Minimally invasive mitral valve surgery: a systematic safety analysis

Kinsing Ko #  1 , Thom L de Kroon #  2 , Marco C Post  3   4 , Johannes C Kelder  3 , Karen F Schut  5 , Nabil Saouti #  2 , Bart P van Putte #  2   5
Affiliations

Minimally invasive mitral valve surgery: a systematic safety analysis

Kinsing Ko et al. Open Heart. 2020 Oct.

Abstract

Objective: Minimally invasive surgery is increasingly adopted as an alternative to conventional sternotomy for mitral valve pathology in many centres worldwide. A systematic safety analysis based on a comprehensive list of pre-specified 30-day complications defined by the Mitral Valve Academic Consortium (MVARC) criteria is lacking. The aim of the current study was to systematically analyse the safety of minimally invasive mitral valve surgery in our centre based on the MVARC definitions.

Methods: All consecutive patients undergoing minimally invasive mitral valve surgery through right mini-thoracotomy in our institution within 10 years were studied retrospectively. The primary outcome was a composite of 30-day major complications based on MVARC definitions.

Results: 745 patients underwent minimally invasive mitral valve surgery (507 repair, 238 replacement), with a mean age of 62.9±12.3 years. The repair was successful in 95.8%. Overall 30-day mortality was 1.2% and stroke rate 0.3%. Freedom from any 30-day major complications was 87.2%, and independent predictors were left ventricular ejection fraction <50% (OR 1.78; 95% CI 1.02 to 3.02) and estimated glomerular filtration rate <60 mL/min/1.73 m2 (OR 1.98; 95% CI 1.17 to 3.26).

Conclusions: Minimally invasive mitral valve surgery is a safe technique and is associated with low 30-day mortality and stroke rate.

Keywords: MVARC; minimally invasive mitral valve surgery; predictors for complications; safety analysis.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flowchart of mitral valve repairability.
Figure 2
Figure 2
Forest plot of independent predictors for 30-day major complications. GFR, glomerular filtration rate.
Figure 3
Figure 3
Forest plot of independent predictors for any 30-day complications. GFR, glomerular filtration rate.
See this image and copyright information in PMC

References

    1. Davierwala PM, Seeburger J, Pfannmueller B, et al. Minimally invasive mitral valve surgery: “The Leipzig experience”. Ann Cardiothorac Surg 2013;2:744–50. 10.3978/j.issn.2225-319X.2013.10.14 - DOI - PMC - PubMed
    1. Glauber M, Miceli A, Canarutto D, et al. Early and long-term outcomes of minimally invasive mitral valve surgery through right minithoracotomy: a 10-year experience in 1604 patients. J Cardiothorac Surg 2015;10:181. 10.1186/s13019-015-0390-y - DOI - PMC - PubMed
    1. Grossi EA, Galloway AC, LaPietra A, et al. Minimally invasive mitral valve surgery: a 6-year experience with 714 patients. Ann Thorac Surg 2002;74:660–4. 10.1016/s0003-4975(02)03754-2 - DOI - PubMed
    1. Modi P, Rodriguez E, Hargrove WC, et al. Minimally invasive video-assisted mitral valve surgery: a 12-year, 2-center experience in 1178 patients. J Thorac Cardiovasc Surg 2009;137:1481–7. 10.1016/j.jtcvs.2008.11.041 - DOI - PubMed
    1. Dogan S, Aybek T, Risteski PS, et al. Minimally invasive port access versus conventional mitral valve surgery: prospective randomized study. Ann Thorac Surg 2005;79:492–8. 10.1016/j.athoracsur.2004.08.066 - DOI - PubMed

MeSH terms