Minimally Invasive Versus Sternotomy Approach for Mitral Valve Surgery: A Propensity Analysis

Iribarne, Alexander; Russo, Mark J.; Easterwood, Rachel; Hong, Kimberly N.; Yang, Jixiang; Cheema, Faisal H.; Smith, Craig R.; Argenziano, Michael

doi:10.1016/j.athoracsur.2010.06.034

Cited by 114 publications

(113 citation statements)

References 30 publications

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“…Causes of death were stroke in one case, adult respiratory distress syndrome in one case, and post-operative low output in one case. Iribarne et al (2010) showed no significant difference in peri-operative mortality (1.8% vs. 1.8%; P=0.622) or one-year mortality (5.0% vs. 3.9%; P=0.599) between the ALMT and MS groups. According to the results of the metaanalysis, three studies mentioned equivalent perioperative mortality between ALMT and MS (Iribarne et al, 2010;Holzhey et al, 2011;Speziale et al, 2011), demonstrating no significant difference between these two procedures (1190 patients; OR=1.18, 95% CI: 0.61-2.30; P=0.62) (Table 2; Fig.…”

Section: Peri-operative Mortalitymentioning

confidence: 85%

“…Two studies, Chitwood et al (1997) and Iribarne et al (2012), were excluded because additional inclusive data were found from the same groups of Felger et al (2001) and Iribarne et al (2010), respectively. In total, we identified 379 studies by searching databases.…”

Section: Resultsmentioning

confidence: 99%

“…Five published reports were identified: one RCT (Speziale et al, 2011) and four case-control studies (Felger et al, 2001;de Vaumas et al, 2003;Iribarne et al, 2010;Holzhey et al, 2011) (Table 1). Two studies, Chitwood et al (1997) and Iribarne et al (2012), were excluded because additional inclusive data were found from the same groups of Felger et al (2001) and Iribarne et al (2010), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of re-operation for bleeding in ALMT was found to be equivalent to that achieved with traditional sternotomy. Four studies met the inclusion criteria (Felger et al, 2001;Iribarne et al, 2010;Holzhey et al, 2011;Speziale et al, 2011) and showed no significant difference between ALMT and MS (OR=1.27, 95% CI: 0.75-2.17; P=0.37) ( Table 2; Fig. 3).…”

Section: Re-operation For Bleedingmentioning

confidence: 99%

“…The largest study, by Iribarne et al (2010), included 764 patients. The incidence of re-operation for bleeding in ALMT was found to be equivalent to that achieved with traditional sternotomy.…”

Section: Re-operation For Bleedingmentioning

confidence: 99%

See 4 more Smart Citations

Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

Ding

Jiang

Tao

et al. 2014

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods: One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results: ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions: Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

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