Propensity Matched Comparison Of Outcomes Following Minimally Invasive Vs Conventional Mitral Valve Repair
Enoch Akowuah1, Simon Kendall1, Andrew Goodwin1, Ralph White1, Omowumi Folaranmi1, Mohamed Allam1, Christopher Takyi2.
1The James Cook University Hospital, Middlesbrough, United Kingdom, 2Newcastle University Medical School, Newcastle, United Kingdom.
BACKGROUND: Recent NICE guidelines suggest minimally invasive mitral valve repair surgery should be offered to all patients who are suitable but comparative data supporting this approach is lacking. The aim of this study was to compare outcomes following both minimally invasive and conventional approaches to mitral valve repair. METHODS: This study retrospectively compared outcomes between patients undergoing isolated mitral valve repair at our institution between 2015 to 2020. Euroscore II was used to generate the propensity scores for patients in the conventional and minimally invasive groups. Of 238 patients, 1:1 propensity score matching was performed for the closest neighbours yielding 152 matched cases in total with 76 patients in each group.
RESULTS: For the 152 matched patients, there was no difference in mean Euroscore II (1.53 ± 1.02 (p = 1.000)). There were no cases of in-hospital mortality in the minimally invasive group, and 1 case out of 76 in the conventional group. Mean total length of hospital stay was significantly lower in the minimally invasive group (6.68 ± 3.61 vs 8.62 ± 6.08, p<0.014). Following surgery, patients with mild residual mitral regurgitation or less were 94.7% in the minimally invasive group vs 96.1% in the conventional group, p =0.6804. Incidence of re-operation for bleeding was not significantly different (2.6% in the minimally invasive group vs 3.9%, p=0.6513) neither was the rate of blood transfusion at 9.2% in both groups.
CONCLUSIONS: This study shows that minimally invasive mitral valve repair is as safe as conventional mitral valve repair. A significant difference in length of stay after surgery may have resource and quality of life implications.
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