Long-Term Results of Minimally Invasive Mitral Valvuloplasty: Insights From a 12-Year Single-Center Experience

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiac Surgery Pub Date : 2025-01-03 DOI:10.1155/jocs/7846083

Chiaki Aichi, Mototsugu Tamaki, Yusuke Imamura, Yuichiro Fukumoto, Hideki Kitamura

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Abstract

Purpose: The safety and long-term durability of minimally invasive mitral valvuloplasty (MIMVP) remain controversial. This study aimed to compare the perioperative and long-term outcomes of minimally invasive mitral valve surgery (MIMVS) and conventional sternotomy.

Methods: This study included 476 patients who underwent mitral valve surgeries at our institution between January 2011 and December 2023. Patients were classified according to whether they underwent sternotomy: the nonsternotomy (NS: 271 cases) and sternotomy (S: 205 cases) groups. Perioperative and long-term outcomes were compared between the two groups.

Results: The NS group had a lower preoperative age and EuroScore II. In the S group, the left ventricular ejection fraction was lower, while the left ventricular end-systolic diameter and left atrial diameter were larger. Operative time, cardiopulmonary bypass time, and aortic cross-clamp time were longer in the NS group. Postoperative atrial fibrillation, more transfusion, and increased length of hospital stay were more frequent in the S group. The 10-year freedom from reoperation and 10-year survival rates in the NS and S groups were 98.1% vs. 93.6% (p = 0.07) and 94.8% vs. 86.9%, respectively (p = 0.08), with no significant differences.

Conclusion: MIMVP demonstrates noninferior perioperative and long-term outcomes compared with conventional sternotomy.

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微创二尖瓣成形术的长期结果：来自12年单中心经验的见解

目的：微创二尖瓣成形术（MIMVP）的安全性和长期耐久性仍存在争议。本研究旨在比较微创二尖瓣手术（MIMVS）与传统胸骨切开术的围手术期和远期疗效。方法：本研究纳入2011年1月至2023年12月在我院接受二尖瓣手术的476例患者。根据是否行胸骨切开术将患者分为非胸骨切开术组（NS: 271例）和胸骨切开术组（S: 205例）。比较两组患者围手术期及远期疗效。结果：NS组术前年龄和EuroScore均较低。S组左室射血分数较低，左室收缩末期内径和左房内径较大。NS组手术时间、体外循环时间、主动脉交叉夹夹时间均较NS组长。术后房颤、输血增多、住院时间延长在S组更为常见。NS组和S组10年再手术自由度和10年生存率分别为98.1%比93.6% （p = 0.07）和94.8%比86.9% (p = 0.08)，差异无统计学意义。结论：与常规胸骨切开术相比，MIMVP具有良好的围手术期和远期疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.