Minimally invasive mitral valve surgery: a systematic safety analysis

Abstract

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.

Minimally Invasive Cardiac Surgery in Colombia: Evolution and the Impact of International Training

“…Groups from the Netherlands have reported 1.2% 30-day mortality rates, and success rates of 95.8%. 5 Other teams from Italy have shown mortality rates of 1.1% and success rates of 91.1% at 10 years. 6 In parallel, Colombian mortality rates have been as low as 0% at 30 days with success rates of 97.4% at 5 years.…”

State-of-the-Art Review: Technical and Imaging Considerations in Novel Transapical and Port-Access Mitral Valve Chordal Repair for Degenerative Mitral Regurgitation

“…In our high-volume MIMVr center, our main strategy to repair isolated prolapse of the pMVL is by the “respect” technique described by Patrick Perrier ( 15 ) in which the prolapsing pMVL segment is corrected by implantation of polytetrafluoroethylene (PTFE) neochordae from the fibrous parts of the papillary muscle complexes in combination with an annuloplasty ring. We will therefore focus on this technique and we will describe our procedural technique step-by-step, based on the Leipzig approach ( 16 , 17 ) and also the (premeasured) loop technique as described by von Oppell and Mohr ( 18 ).…”

The Impact of Biomedical Engineering on the Development of Minimally Invasive Cardio-Thoracic Surgery

“…On the other hand, being aware of the risks associated with MICS is the key to risk control, which enables safe and good results in patients with pulmonary hypertension [33]. Although Ko et al described excellent safety outcomes in a large cohort of patients, their article also pointed out rare risks that deserve better control such as bleeding [34]. Smart devices can facilitate surgery in many ways either by smoothening the implantation or skipping a process step when rapid deployment devices are used for valve replacement, similar to wire-mounted devices [35].…”