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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Minimally Invasive Approaches Are Safe for Concomitant Mitral and Tricuspid Valve Surgery
Raymond J Strobel1, Robert B Hawkins2, J Hunter Mehaffey1
1Division of Cardiac Surgery, University of Virginia, Charlottesville, VA, USA.
Innovations (Philadelphia, Pa.)
|October 18, 2022
Summary
Concomitant tricuspid surgery during mitral valve repair increases operative risk, especially with sternotomy. A minimally invasive thoracotomy (MICS) approach offers a safer alternative for patients needing both procedures.
Area of Science:
- Cardiac Surgery
- Thoracic Surgery
- Minimally Invasive Surgery
Background:
- Concomitant tricuspid surgery during mitral valve surgery is linked to increased operative risk.
- Minimally invasive cardiac surgery (MICS) techniques are increasingly adopted for various cardiac procedures.
Purpose of the Study:
- To evaluate the risk associated with concomitant tricuspid surgery during mitral valve surgery.
- To compare the safety and outcomes of MICS versus sternotomy for patients requiring concomitant tricuspid surgery.
Main Methods:
- Retrospective analysis of 772 patients undergoing mitral valve surgery between 2010 and 2020.
- Patients were stratified based on MICS or sternotomy approach.
- Multivariable logistic regression was used to assess risk-adjusted outcomes, including major morbidity and mortality.
Main Results:
- 138 patients (17.9%) had concomitant tricuspid surgery.
- Sternotomy approach for concomitant tricuspid surgery showed nearly double the odds of morbidity/mortality (adjOR = 1.86, P = 0.049).
- MICS approach for concomitant tricuspid surgery did not increase the risk of composite outcomes (adjOR = 0.66, P = 0.543).
Conclusions:
- Concomitant tricuspid surgery during mitral valve surgery adds risk to the overall procedure.
- A minimally invasive approach (MICS) appears to be a safe option for select patients requiring concomitant tricuspid valve surgery.
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