Minimally invasive mitral valve surgery is associated with a low rate of complications

Kastengren, Mikael; Svenarud, Peter; Ahlsson, Anders; Dalén, Magnus

doi:10.1111/joim.12974

Cited by 21 publications

(12 citation statements)

References 59 publications

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“… 7 There is currently one large trial running in the UK (UK Mini Mitral Trial), for which we are still awaiting the results. 8 Nonetheless, increasingly centres worldwide report promising results, 9 10 which suggests that MIMVS is reproducible in a safe way with results equal to sternotomy. Most clearly reported benefits of MIMVS over sternotomy are faster return to daily activities and higher patient’s satisfaction of cosmetics.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive mitral valve surgery: a systematic safety analysis

Kroon

Post

et al. 2020

Open Heart

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ObjectiveMinimally 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.MethodsAll 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.Results745 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).ConclusionsMinimally invasive mitral valve surgery is a safe technique and is associated with low 30-day mortality and stroke rate.

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Section: Introductionmentioning

confidence: 99%

Minimally invasive mitral valve surgery: a systematic safety analysis

Kroon

Post

et al. 2020

Open Heart

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“…less pain, less blood loss, shorter hospital stay and faster recovery. These advantages have notably and consistently been realised in minimalist surgical mitral valve repair; 18 indeed, with the widely utilised peri-areolar incision developed by Poffo and associates 19 patients experience almost no pain and a near perfect cosmetic result.…”

Section: Advantages Of Totally Endoscopic Transcervical Approach To Savrmentioning

confidence: 99%

Totally Endoscopic Uniportal Surgical Aortic Valve Replacement via Transcervical Approach: How to Do It

Sutherland

Al‐Attar

Smoczyński

et al. 2021

MRAJ

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The number of aortic valve interventions continues to increase. Although transcatheter aortic valve replacement (TAVR) was a milestone in the field, it is quite uncertain whether this technique will completely supplant surgical aortic valve replacement (SAVR) due to its recognized shortcomings and access limitations. However, TAVR can be considered in short-term the competitor to SAVR and therefore, there is a pressing clinical need for a less invasive SAVR procedure, capable of delivering superior outcomes when compared with TAVR, without the level of invasiveness of current approaches to SAVR. Different totally endoscopic aortic valve replacement approaches have been described. Nevertheless, we believe that these can be improved and facilitated by cutting-edge technology such as CoreVista® Retractor and CoreVista® Monitor in the surgical field and the feasibility of a single, unique port access centred upon a small transcervical incision to perform the entire procedure. This paper explores the current state of the art and presents detailed how-to-do-it steps for implementing Totally Endoscopic Uniportal SAVR based upon the Transcervical Approach.

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“…Annuloplasty with a closed, undersized ring is also used in the operation for ischemic MR. 57,59,60 Less perioperative complications (especially blood loss), decreased chances of surgical wound infection, as well as a shorter recovery period, have been the main advantages of MIMVS. 57,61,62 Operative survival rate in multiple retrospective studies has been 100% and mortality rate at 30-day follow up is between 0.2 to 4.8%, depending on patient profile, higher mortality being recorded for patients undergoing MIMVS with concomitant tricuspid valve repair or coronary artery bypass grafting. 60,63,64 Disadvantages of MIMVS, compared to standard sternotomy, include longer CPB time and increased risk of stroke during or immediately after intervention (almost 2.6% of patients have reported ischemic strokes).…”

Section: Transcatheter Mitral Valve Replacementmentioning

confidence: 99%

Mitral valve disease: A view on pathophysiology and management of the most common valve disease in the world

Botezatu

Kakar

Ren

et al. 2020

Preprint

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Objectives: Mitral valve disease is increasingly prevalent. Timely diagnosis and the choice of the right intervention are very important in the early stages, as valvular dysfunction often leads to cardiac failure and even sudden death. The focus of this paper is on the various pathologies of the mitral valve, their etiology, and clinical management. Methods: Mitral regurgitation (MR) can be managed surgically, percutaneously or medically. Treatment methods for primary MR include percutaneous mitral valve (MV) repair, MV replacement, minimally invasive mitral valve surgery (MIMVS), and more recently, robotics. Additionally, conventional sternotomy has been used for both MR and mitral stenosis. Nonetheless, ongoing clinical trials are a clear indicator that the management of valve diseases is continuously evolving. Results: Multiple studies favour MV repair via MIMVS, over conventional sternotomy or percutaneous approach. However, more data is needed to optimize patient selection. Robot assisted repair is a new alternative, but attention should be given to the steep learning curve and medical training of professionals wishing to perform this intervention. Cost effectiveness and possible side effects should be explored by clinical trials as well. While guidelines are fairly straightforward for primary MR, there is insufficient evidence to suggest that surgical treatment is advantageous for secondary MR. Management is usually pharmaceutical and aims to treat symptoms rather than cause. Conclusion: Mitral valve disease remains a medical challenge, but numerous research and clinical trials have been embarked upon to refine old methods and discover new ones to improve treatment success and procedural safety.

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Minimally invasive mitral valve surgery is associated with a low rate of complications

Cited by 21 publications

References 59 publications

Minimally invasive mitral valve surgery: a systematic safety analysis

Minimally invasive mitral valve surgery: a systematic safety analysis

Totally Endoscopic Uniportal Surgical Aortic Valve Replacement via Transcervical Approach: How to Do It

Mitral valve disease: A view on pathophysiology and management of the most common valve disease in the world

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