Introduction: Treatments for cardiovascular
diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter
procedures instead of conventional sternotomy surgery. In this context, we
highlight minimally invasive mitral valve surgery (MIMVS), which has been shown
to be an increasingly solid option with some superior results when compared to
the conventional technique: better pain
control, shorter hospital stays, shorter recovery time, shorter readmission
rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to
evaluate the stages of MIMVS, by primary mitral valve consultation, in our
service and compare these results
with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for
primary mitral valve injury in the Encore Hospital from January 2020 to
February 2023 were analyzed. Tabulation and statistical analysis were performed
using the Microsoft Excel® program. Quantitative variables were presented as
means, standard deviations. Results: 46 patients were enrolled in our
study (Age: 59.1 ± 12.4 years old; 60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%,
plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in
an intensive care bed
References
[1]
Ko, K., De Kroon, T.L., Post, M.C., Kelder, J.C., Schut, K.F., Saouti, N. and Van Putte, B.P. (2020) Minimally Invasive Mitral Valve Surgery: A Systematic Safety Analysis. Open Heart, 7, e001393. https://doi.org/10.1136/openhrt-2020-001393
Vervoort, D., Nguyen, D.H. and Nguyen, T.C. (2020) When Culture Dictates Practice: Adoption of Minimally Invasive Mitral Valve Surgery. Innovations (Phila), 15, 406-409. https://doi.org/10.1177/1556984520948644
[4]
Paparella, D., Fattouch, K., Moscarelli, M., Santarpino, G., Nasso, G., Guida, P., Margari, V., Martinelli, L., Coppola, R., Albertini, A., Del Giglio, M., Gregorini, R. and Speziale, G. (2020) Current Trends in Mitral Valve Surgery: A Multicenter National Comparison between Full-Sternotomy and Minimally-Invasive Approach. International Journal of Cardiology, 306, 147-151. https://doi.org/10.1016/j.ijcard.2019.11.137
[5]
Nakayama, T., Nakamura, Y., Kanamori, K., Hirano, T., Kuroda, M., Nishijima, S., Ito, Y., Tsuruta, R. and Hori, T. (2020) Early and Midterm Results of Minimally Invasive Aortic and Mitral Valve Surgery via Right Mini-Thoracotomy. Journal of Cardiothoracic Surgery, 35, 35-39. https://doi.org/10.1111/jocs.14313
[6]
Santana, O., Larrauri-Reyes, M., Zamora, C. and Mihos, C.G. (2016) Is a Minimally Invasive Approach for Mitral Valve Surgery More Cost-Effective than Median Sternotomy? Interdisciplinary CardioVascular and Thoracic Surgery, 22, 97-100. https://doi.org/10.1093/icvts/ivv269
[7]
Goldfarb, M., Drudi, L., Almohammadi, M., Langlois, Y., Noiseux, N., Perrault, L., Piazza, N. and Afilalo, J. (2015) Outcome Reporting in Cardiac Surgery Trials: Systematic Review and Critical Appraisal. Journal of the American Heart Association, 4, e002204. https://doi.org/10.1161/JAHA.115.002204
[8]
Stone, G.W., Adams, D.H., Abraham, W.T., Kappetein, A.P., Généreux, P., Vranckx, P., Mehran, R., Kuck, K.H., Leon, M.B., Piazza, N., Head, S.J., Filippatos, G. and Vahanian, A.S. (2015) Clinical Trial Design Principles and Endpoint Definitions for Transcatheter Mitral Valve Repair and Replacement: Part 2: Endpoint Definitions: A Consensus Document from the Mitral Valve Academic Research Consortium. European Heart Journal, 36, 1878-1891. https://doi.org/10.1093/eurheartj/ehv333
[9]
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012) KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International, 2, 1-138.
[10]
Carpentier, A. (1983) Cardiac Valve Surgery—The “French Correction”. The Journal of Thoracic and Cardiovascular Surgery, 86, 323-337. https://doi.org/10.1016/S0022-5223(19)39144-5
[11]
Davierwala, P.M., Seeburger, J., Pfannmueller, B., Garbade, J., Misfeld, M., Borger, M.A. and Mohr, F.W. (2013) Minimally Invasive Mitral Valve Surgery: “The Leipzig Experience”. Annals of Cardiothoracic Surgery, 2, 744-750.
[12]
Burns, D.J.P., Wierup, P. and Gillinov, M. (2021) Minimally Invasive Mitral Surgery: Patient Selection and Technique. Cardiology Clinics, 39, 211-220. https://doi.org/10.1016/j.ccl.2021.01.003
[13]
Detter, C., Boehm, D.H. and Reichenspurner, H. (2004) Minimally Invasive Valve Surgery: Different Techniques and Approaches. Expert Review of Cardiovascular Therapy, 2, 239-251. https://doi.org/10.1586/14779072.2.2.239
[14]
Arom, K.V. and Emery, R.W. (1997) Minimally Invasive Mitral Operations. The Annals of Thoracic Surgery, 63, 1219-1220. https://doi.org/10.1016/S0003-4975(97)00136-7
[15]
Svensson, L.G. and D’Agostino, R.S. (1998) “J” Incision Minimal-Access Valve Operations. The Annals of Thoracic Surgery, 66, 1110-1112. https://doi.org/10.1016/S0003-4975(98)00655-9
[16]
Navia, J.L. and Cosgrove, D.M. (1996) Minimally Invasive Mitral Valve Operations. The Annals of Thoracic Surgery, 62, 1542-1544. https://doi.org/10.1016/0003-4975(96)00779-5
[17]
Doty, D.B., DiRusso, G.B. and Doty, J.R. (1998) Full-Spectrum Cardiac Surgery through a Minimal Incision: Mini-Sternotomy (Lower Half) Technique. The Annals of Thoracic Surgery, 65, 573-577. https://doi.org/10.1016/S0003-4975(97)01368-4
[18]
Van Praet, K.M., Stamm, C., Sündermann, S.H., Meyer, A., Unbehaun, A., Montagner, M., Nazari Shafti, T.Z., Jacobs, S., Falk, V. and Kempfert, J. (2018) Minimally Invasive Surgical Mitral Valve Repair: State of the Art Review. Interventional Cardiology Journal, 13, 14-19. https://doi.org/10.15420/icr.2018.13.2.ER1
[19]
Castro Neto, J.V., Melo, E., Fernandes, J., Gomes, R., Freitas, C., Machado, J., Martins, F., Barbosa, A., Oliveira, B. and Gondim, C. (2012) Mitral Valve and Atrial Septal Defect Surgery: Minimally Invasive or Sternotomy Approach. Arquivos Brasileiros de Cardiologia, 99, 681-687. https://doi.org/10.1590/S0066-782X2012005000064
[20]
Sündermann, S.H., Czerny, M. and Falk, V. (2015) Open vs. Minimally Invasive Mitral Valve Surgery: Surgical Technique, Indications and Results. Cardiovascular Engineering and Technology, 6, 160-166. https://doi.org/10.1007/s13239-015-0210-5
[21]
David, T.E., David, C.M., Tsang, W., Lafreniere-Roula, M. and Manlhiot, C. (2019) Long-Term Results of Mitral Valve Repair for Regurgitation Due to Leaflet Prolapse. Journal of the American College of Cardiology, 74, 1044-1053. https://doi.org/10.1016/j.jacc.2019.06.052
[22]
Suri, R.M., Schaff, H.V., Dearani, J.A., Sundt, T.M., Daly, R.C., Mullany, C.J., Enriquez-Sarano, M. and Orszulak, T.A. (2006) Survival Advantage and Improved Durability of Mitral Repair for Leaflet Prolapse Subsets in the Current Era. The Annals of Thoracic Surgery, 82, 819-826. https://doi.org/10.1016/j.athoracsur.2006.03.091
[23]
Costa, F.D.A.D., Colatusso, D.F.F., Martin, G.L.D.S., Parra, K.C.S., Botta, M.C., Balbi Filho, E.M., Veloso, M., Miotto, G., Ferreira, A.D.A. and Colatusso, C. (2018) Long-Term Results of Mitral Valve Repair. Brazilian Journal of Cardiovascular Surgery, 33, 23-31.
[24]
Sündermann, S.H., Sromicki, J., Rodriguez Cetina Biefer, H., Seifert, B., Holubec, T., Falk, V. and Jacobs, S. (2014) Mitral Valve Surgery: Right Lateral Minithoracotomy or Sternotomy? A Systematic Review and Meta-Analysis. The Journal of Thoracic and Cardiovascular Surgery, 148, 1989-1995.e4. https://doi.org/10.1016/j.jtcvs.2014.01.046
[25]
Al Otaibi, A., Gupta, S., Belley-Cote, E.P., Alsagheir, A., Spence, J., Parry, D. and Whitlock, R.P. (2017) Mini-Thoracotomy vs. Conventional Sternotomy Mitral Valve Surgery: A Systematic Review and Meta-Analysis. The Journal of Cardiovascular Surgery (Torino), 58, 489-496. https://doi.org/10.23736/S0021-9509.16.09603-8
[26]
Gammie, J.S., Zhao, Y., Peterson, E.D., O’Brien, S.M., Rankin, J.S. and Griffith, B.P. (2010) J. Maxwell Chamberlain Memorial Paper for Adult Cardiac Surgery. Less-Invasive Mitral Valve Operations: Trends and Outcomes from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. The Annals of Thoracic Surgery, 90, 1401-1408, 1410.e1. https://doi.org/10.1016/j.athoracsur.2010.05.055
[27]
Shih, E., Squiers, J.J. and DiMaio, J.M. (2021) Systematic Review of Minimally Invasive Surgery for Mitral Valve Infective Endocarditis. Innovations (Phila), 16, 244-248. https://doi.org/10.1177/1556984521997086