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OBJECTIVE: To update the current evidence of mitral valve surgery through a lateral minithoracotomy versus median sternotomy.
METHODS: We performed a comprehensive literature research regarding studies comparing mitral valve surgery through a right-lateral minithoracotomy and median sternotomy in MEDLINE, EMBASE, Cochrane Central, CTSnet and Google Scholar for the most recent literature up to April 2013. From the studies found in the literature we performed a systematic review and meta-analysis.
RESULTS: 20’000 patients out of 46 studies were included in this study. Stroke rate and all-cause mortality up to 30 days was similar in both groups. The length of stay in the ICU respirator dependence and hospital stay were significantly shorter in the minimally invasive (MIVS)-group. Furthermore, blood drainage volume and blood transfusions were decreased in the MIVS-group. On the contrary cardiopulmonary bypass time, cross clamp time and procedure’s length were longer in the MIVS-group.
Postoperative new atrial fibrillation was less in the MIV-group. Aortic dissections occurred more in the MIVS-group. The rate of re-thoracotomies and postoperative renal failure was similar in both groups.
CONCLUSIONS: MIVS and conventional mitral valve surgery show a similar perioperative outcome. Minimally invasive mitral valve surgery seems to be favorable in regards of resource related outcome.