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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
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What Does Minimally Invasive Mitral Valve Surgery Really Mean? Defining Totally Endoscopic Mitral Valve Surgery
Jessica Katsiroubas1, Emily Manin2, Jake L Rosen3
1Department of Surgery, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York.
Surgical Technology International
|October 18, 2023
Summary
Totally endoscopic mitral valve surgery (TEMVS), defined by small incisions and no rib spreading, demonstrates low 30-day mortality. This minimally invasive approach shows uncommon rates of major complications, making it a safe option for mitral valve repair.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
- Medical Technology
Background:
- Minimally invasive mitral valve surgery is increasingly common but lacks a standardized definition, hindering outcome analysis.
- Current "minimally invasive" techniques often still involve significant incisions and rib spreading.
- A formal definition is needed to accurately assess the safety and efficacy of the most advanced minimally invasive mitral valve procedures.
Purpose of the Study:
- To formally define totally endoscopic mitral valve surgery (TEMVS).
- To assess the outcomes and safety of TEMVS based on a comprehensive literature review and meta-analysis.
Main Methods:
- A systematic literature search was conducted across PubMed, Cochrane Library, and EMBASE.
- Totally endoscopic mitral valve surgery (TEMVS) was defined as procedures using incisions <3cm without rib spreading.
- Primary outcome was 30-day mortality; secondary outcomes included myocardial infarction, stroke, reoperation, and renal failure.
Main Results:
- The meta-analysis included 33 studies with 6031 patients undergoing TEMVS.
- The 30-day mortality rate was low at 0.33%.
- Frequent complications included early reoperation (2.12%) and prolonged ventilation (1.46%); myocardial infarction, stroke, and renal failure were each <1%.
Conclusions:
- A formal definition for TEMVS (incisions <3cm, no rib spreading) is proposed.
- TEMVS is associated with low 30-day mortality.
- Adverse sequelae following TEMVS are uncommon, supporting its safety and efficacy.
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