Abstract
Background and aim of the study - The debate on the
usefulness of the minimally invasive approach in mitral valve surgery is
still open. The aim of this study is to describe a single-center case
series of all comers undergoing minimally invasive mitral valve
reconstruction.
Methods - From 2010 to 2019, all the data recorded in
the medical records of 893 consecutive patients undergoing mitral valve
reconstruction through a right mini-thoracotomy were retrospectively
collected. All patients were contacted by telephone for remote
evaluation and integration of echocardiographic information on surgical
results.
Results - Mean age was 62.2±14.5; 447 (50%) were female
and mean log EuroSCORE was 2.5±2.8%. At a mean follow-up of 4.1 ± 2.2
years (median 3.9), a total of 24 deaths (2.68%) were recorded.
Twenty-four patients required rehospitalization for cardiac causes, 13
(1.4%) patients had at least moderate mitral insufficiency on follow-up
echocardiography and, of these, 7 patients underwent reoperation
(0.8%). The cumulative hazard showed that 8.3% of patients experienced
at least one event at 5 years. NYHA class improved significantly with
874 patients in NYHA class I, 13 in NYHA class II, 6 in NYHA class III,
and 0 in NYHA class IV at last follow-up (p <0.001 from
baseline as reference point).
Conclusions – In a high-volume center, mitral valve
surgery using a minimally invasive approach is a feasible treatment
option for all-comers and is associated with excellent results that are
maintained at clinical and echocardiographic follow-up.