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Objective: To review a single center experience with minimally invasive mitral valve surgery (MIMVS) over a 8-year period.
Methods: A retrospective study was undertaken of prospectively collected data on consecutive patients undergoing MIMVS via right minithoracotomy by six surgeons between January 2003 and October 2011.
Results: A total of 1155 patients underwent MIMVS via right minithoracotomy, of whom 859 (74.3%) patients had mitral valve repair and 296 (25.7 %) patients received mitral valve replacement. The mean age was 62.3±13.4 years, 569 (49.2%) patients were female, mean ejection fraction was 59.1±10%, 120 patients (10.3%) had previous cardiac operations and 57 (5%) patients had active endocarditis . Direct aortic cannulation was achieved in 1114 (98%) patients. Overall in-hospital mortality was 1.3% (15 patients). Mortality for mitral valve repair and replacement were 0.5% (4 patients, predicted median EuroSCORE 4%, range interquartile 2-6) and 3.7% (11 patients, predicted median EuroSCORE 7%, range interquartile 4-14,8 %), respectively. In the mitral valve repair group, 661 (76.9%) patients received mitral valve repair (leaflet resection, sliding, neochordae placement) with either annuloplasty (n=629, 95,1%) or without annuloplasty (n=32, 4.9%) and 198 (23%) patients received only a mitral valve annuloplasty. In patients who had mitral valve replacement, a mechanical and biological valves were implanted in 130 (43.9%) and 166 (56.1%), respectively. Twenty-six (2.2%) patients had conversion to sternotomy. Concomitant tricuspid valve repair was performed in 153 patients (13.25) and concomitant ablation of atrial fibrillation was performed in 120 patients (10.4%). At discharge, 98 % of patients showed no or trivial residual mitral regurgitation.
Conclusions: Minimally invasive mitral valve surgery is a safe and reproducible approach associated with low mortality and high rate of mitral valve repair.