Minimally invasive mitral valve surgery is associated with excellent resource utilization, cost, and outcomes

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Minimally Invasive Procedures

Background:

• Minimally invasive mitral valve surgery (mini-MVR) presents potential benefits but often excludes high-risk patients.
• Evaluating mini-MVR in a representative patient cohort is crucial for understanding its real-world applicability and resource implications.

Purpose of the Study:

• To assess the outcomes and resource utilization of minimally invasive mitral valve surgery (mini-MVR) in a broad patient population.
• To compare mini-MVR with conventional approaches regarding morbidity, cost, and length of stay.

Main Methods:

• Retrospective analysis of 478 mitral valve surgery patients (2011-2016), comparing mini-MVR (21%) with conventional approaches.
• Propensity-score matching was used to balance preoperative characteristics between the two surgical groups.
• Primary outcomes included resource utilization: total cost, discharge to facility, and readmission rates.

Main Results:

• Excellent outcomes were observed in both groups, with similar major morbidity rates (9.5% vs 10.8%).
• Mini-MVR showed significantly lower transfusion rates (11% vs 27%) and shorter ventilator times (3.7 vs 6.0 hours).
• While surgical and implant costs were higher for mini-MVR, overall hospital costs were equivalent due to savings in ancillary and blood costs.

Conclusions:

• Minimally invasive mitral valve surgery (mini-MVR) demonstrates excellent clinical outcomes and favorable resource utilization in a real-world setting.
• Increased surgical and implant costs associated with mini-MVR are offset by reductions in transfusions and ancillary expenses, resulting in comparable overall hospital costs.
• Mini-MVR is a viable option for mitral valve repair and replacement, offering comparable economic and clinical benefits to traditional methods.