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Updated: Jul 29, 2025
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Transaxillary approach enhances postoperative recovery after mitral valve surgery
Pietro Giorgio Malvindi1, Manuel Wilbring2, Veronica De Angelis2
1Cardiac Surgery Unit, Lancisi Cardiovascular Center, Ospedali Riuniti delle Marche, Polytechnic University of Marche, Ancona, Italy.
Summary
Minimally invasive mitral valve surgery via a right transaxillary (TAxA) approach offers outcomes comparable to conventional full sternotomy (FS). TAxA surgery leads to shorter recovery times and increased home discharge rates, improving patient recovery after mitral valve repair.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Thoracic Surgery
Background:
- Minimally invasive mitral valve surgery utilizes various thoracic incisions and cardiopulmonary bypass techniques.
- Conventional full sternotomy (FS) is a standard approach for mitral valve surgery.
Purpose of the Study:
- To compare early outcomes of a simplified minimally invasive mitral valve surgery using a right transaxillary (TAxA) approach versus conventional full sternotomy (FS).
Main Methods:
- A propensity-matched analysis compared 454 TAxA patients with 667 FS patients who underwent mitral valve surgery between 2017-2022.
- Exclusion criteria included associated aortic/coronary artery surgery, infective endocarditis, redo, and urgent operations.
Main Results:
- The transaxillary (TAxA) approach showed a 30-day mortality of 0.25% and a 0.7% postoperative cerebral stroke rate.
- TAxA surgery resulted in significantly shorter intubation and intensive care unit (ICU) stays (P < 0.001).
- 30% of TAxA patients were discharged home after 8 days, compared to 5% of FS patients (P < 0.001).
Conclusions:
- The transaxillary (TAxA) approach offers comparable early outcomes to full sternotomy (FS) for mitral valve surgery.
- TAxA access is associated with reduced mechanical ventilation, shorter ICU and hospital stays.
- Patients undergoing TAxA mitral surgery have a higher likelihood of direct home discharge post-recovery.
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