Minimally invasive mitral valve surgery.

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Techniques

Background:

• Growing demand for minimally invasive cardiac surgery due to patient cosmesis, satisfaction, and reduced trauma.
• Minimally invasive mitral valve surgery (MIMVS) has evolved over 25 years, demonstrating significant benefits.

Purpose of the Study:

• To review patient selection criteria for MIMVS.
• To compare the merits and drawbacks of MIMVS versus conventional sternotomy.
• To detail procedural aspects of MIMVS, including anesthetic management, surgical technique, and cardiopulmonary bypass (CPB).

Main Methods:

• Review of existing literature and clinical experience with MIMVS.
• Discussion of patient selection, procedural techniques, and myocardial protection strategies.
• Emphasis on the importance of a multidisciplinary team approach for program development.

Main Results:

• MIMVS provides superior cosmetic results, enhanced recovery, and improved patient satisfaction.
• Clinical outcomes, quality, and safety of MIMVS are equivalent to the standard sternotomy approach.
• MIMVS is particularly beneficial for specific patient groups, such as those requiring redo mitral valve surgery.

Conclusions:

• MIMVS is a safe and effective alternative to sternotomy for mitral valve surgery.
• Careful patient selection is crucial, especially during the initial phase of establishing an MIMVS program.
• With experience, complex mitral valve repairs can be successfully performed using a minimally invasive approach, yielding excellent outcomes.