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Psychological Effects of Skin Incision Size in Minimally Invasive Valve Surgery Patients.

Alessandra Piarulli^1,2, Giovanni Alfonso Chiariello^1,2, Piergiorgio Bruno¹

¹Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy.

Innovations (Philadelphia, Pa.)

|September 29, 2020

Summary

Minimally invasive cardiac valve surgery (MIVS) offers significant psychological benefits, including reduced depression and anxiety, compared to conventional sternotomy. Patients undergoing MIVS also reported better quality of life and improved perception of their surgical scars.

Keywords:

heart valve surgery minimally invasive surgery psychological outcome skin incision

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Area of Science:

Cardiovascular Surgery
Psychological Medicine
Quality of Life Research

Background:

Minimally invasive cardiac valve surgery (MIVS) is known for clinical benefits.
Postoperative mental status following MIVS has not been thoroughly assessed using dedicated psychological tests.
Patient perception of surgical scars, body image, and cosmetic outcomes are important but understudied aspects of MIVS.

Purpose of the Study:

To investigate the psychological benefits of MIVS.
To evaluate the impact of MIVS on patient perception of surgical scars, body image, and cosmetic results.
To compare psychological outcomes between MIVS and conventional sternotomy (CS).

Main Methods:

A study involving 87 patients undergoing heart valve surgery between 2016-2017.
Patients were divided into conventional sternotomy (CS; n=48) and MIVS (n=39) groups.
Preoperative and 6-month postoperative psychological assessments included Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI-Y), EuroQol-5D (EQ-5D), Body Image Questionnaire (BIQ), and Patient and Observer Scar Assessment Scale (POSAS v2.0).

Main Results:

MIVS patients demonstrated significantly lower depression (BDI-II, P=0.04) and anxiety (STAI-Y, P=0.04) symptoms.
MIVS was associated with better quality of life, indicated by significant differences in two EQ-5D indices (P=0.03, P=0.01).
MIVS patients reported significantly better scar perception (BIQ and POSAS v2.0 scores) compared to CS patients.

Conclusions:

MIVS provides significant esthetic and psychological advantages over conventional sternotomy.
These benefits include improved patient psychological well-being and satisfaction with scar appearance.
The findings support considering MIVS for enhanced patient outcomes in heart valve surgery.