Is minimally invasive thoracoscopic surgery the new benchmark for treating mitral valve disease?

Abstract

The treatment of mitral valve disease remains dynamic; surgeons and patients must now choose between many different surgical options when addressing mitral regurgitation and mitral stenosis. Notably, advances in imaging and surgical instrumentation allow surgeons to perform less invasive mitral valve surgery that spares the sternum. With favorable long-term data now emerging, we compare the benefits and risks of thoracoscopic mitral valve surgery with that through conventional sternotomy or surgery that is robotassisted.

Minimally Invasive Mitral Valve Surgery in Re-Do Cases—The New Standard Procedure?

“…For the mitral valve, re-operative procedures performed through a median sternotomy are characterized by substantial mortality and morbidity. 1 The position of the mitral valve under all other cardiac structures makes its exposure chal-lenging, especially in re-do cases when adhesions and scar retraction immobilize the heart to the pericardium. With reoperation rates steadily increasing due to the aging of the population and degeneration of biological prosthesis, cardiac surgeons will have to face more often with operations on the mitral valve as a re-do surgery than they had to in the past.…”

“…It is however a more challenging procedure. 1 We therefore analyzed our experience regarding minimally invasive mitral valve operations at our center.…”

An Unusual Presentation of Acute Severe Mitral Regurgitation

“…Mitral valve surgery is the treatment of choice for acute MR. Mitral valve repair is better than replacement owing to fewer complications, lower operative mortality, and longer survival [ 8 , 9 ]. Early surgery in asymptomatic patients improves clinical outcomes and successful repair rates of 80-90%[ 10 ].…”

Totally thoracoscopic surgical resection of left ventricular benign tumor

“…Small incision approach, total endoscope techniques, and even the da Vinci surgical robot can be used to achieve perfect radical treatment for certain diseases in cardiac surgery. 10 , 11 , 12 , 13 …”