In the recent years minimally invasive mitral valve surgery (MIMVS) has become a well-established and increasingly used option for managing patients with a mitral valve pathology. Nonetheless, whether the purported benefits of MIMVS translate into clinically important outcomes remains controversial. Therefore, in this paper we provide an overview of MIMVS and discuss results, morbidity, mortality, and quality of life following mitral minimally invasive procedures. MIMVS has been proven to be a feasible alternative to the conventional full sternotomy approach with low perioperative morbidity and short-term mortality. Reported benefits of MIMVS include also decreased postoperative pain, improved postoperative respiratory function, reduced surgical trauma, and greater patient satisfaction. Finally, compared to standard surgery, MIMVS demonstrated comparable efficacy across a range of long-term efficacy measures such as freedom from reoperation and long-term survival. 1. Introduction Minimally invasive mitral valve surgery (MIMVS) has been proven as a feasible alternative to conventional full sternotomy approach with low perioperative morbidity and short-term mortality [1, 2]. As a result, MIMVS is being employed increasingly as routine approach in many centers worldwide with excellent short-term and long-term results [3, 4]. During the past years, several studies on outcomes of MIMVS have been published in the literature [5–7]. Furthermore, since the first description of MIMVS by Cohn et al. [8] and Navia and Cosgrove [9] in the mid 1990s, various minimally invasive approaches have been reported including the parasternal, hemisternotomy, minithoracotomy, and totally endoscopic approaches [10–12]. However, despite the differences in surgical approaches, the shared goal of all these MIMVS procedures is to avoid median sternotomy-related complications such as infection, mediastinitis, and nerve injuries [8, 13–19] and, at the same time, to provide a safe and effective option for mitral valve surgery with the clinical benefits associated with a minimal access approach. Nonetheless, whether the supposed benefits of MIMVS translate into clinical favorable outcomes still remains controversial, and there are conflicting opinions about whether minimally invasive surgery is ready for routine uptake in place of conventional open mitral valve surgery. In this paper we provide an overview of MIMVS and discuss results, morbidity, mortality, and quality of life following mitral minimally invasive procedures. 2. Review Criteria Papers selected for this review were
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