Outcomes in minimally invasive double valve surgery

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques
• Comparative Outcomes Analysis

Background:

• Minimally invasive surgery (MIS) is increasingly explored for complex cardiac procedures.
• Double valve surgery presents unique challenges for minimally invasive approaches.
• Evidence on the comparative outcomes of MIS for double valve replacement is evolving.

Purpose of the Study:

• To synthesize current literature on the outcomes of minimally invasive double valve surgeries (MIS).
• To compare MIS outcomes against conventional median sternotomy.
• To identify trends and knowledge gaps in MIS for double valve procedures.

Main Methods:

• Comprehensive literature search from inception to June 2020.
• Inclusion of studies on solo MIS double valve cohorts and comparative studies.
• Narrative synthesis of evidence from identified articles.

Main Results:

• Most studies report similar perioperative and clinical outcomes between MIS and conventional sternotomy.
• MIS demonstrates advantages in cosmetic effects and pain management.
• Longer cardiopulmonary bypass and aortic cross-clamp times are noted with MIS, potentially impacting morbidity and mortality.

Conclusions:

• Minimally invasive double valve surgery is advancing, but literature scarcity suggests slow adoption, possibly due to a learning curve.
• Outcomes are largely comparable to conventional sternotomy.
• Larger, multi-center, randomized trials are needed to fully assess long-term outcomes of both techniques.