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Endoscopic Minimally Invasive Approach Versus Median Sternotomy for Multiple-Valve Surgery: A Propensity-Matched

Saad Salamate¹, Farhad Bakhtiary², Ali Bayram³

¹Department of Cardiac Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. saad.salamate@ukbonn.de.

Advances in Therapy

|November 9, 2024

Summary

This summary is machine-generated.

Endoscopic minimally invasive multiple-valve surgery (MIMVS) shows comparable short-term outcomes to median sternotomy (MS). MIMVS demonstrated a trend towards lower 30-day mortality and reduced transfusion needs, proving its safety and effectiveness.

Keywords:

Endoscopic minimally invasive valve surgery Median sternotomy Multiple-valve surgery Propensity score matching Right anterior mini-thoracotomy

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Area of Science:

Cardiovascular Surgery
Minimally Invasive Techniques
Thoracic Surgery

Background:

Endoscopic minimally invasive valve surgery offers a less invasive alternative to traditional median sternotomy.
Multiple concomitant valve surgeries present unique challenges and require careful outcome assessment.

Purpose of the Study:

To compare the short-term outcomes of endoscopic minimally invasive multiple concomitant valve surgeries (MIMVS) versus median sternotomy (MS).
To evaluate the feasibility, safety, and effectiveness of MIMVS for multiple valve procedures.

Main Methods:

Retrospective collection of data from 317 patients undergoing multiple-valve surgeries at two German institutions (March 2017-March 2023).
Propensity score matching (1:1) to create comparable groups for MIMVS and MS.
Primary endpoint: 30-day mortality. Secondary endpoints included transfusion rates, cardiopulmonary bypass time, aortic cross-clamping time, and length of hospital stay.

Main Results:

After matching, 30-day mortality was 8% for MIMVS vs. 12.5% for MS (p=0.28).
MIMVS group required significantly less blood transfusion (p=0.002).
Cardiopulmonary bypass and aortic cross-clamping times were similar between groups. Intensive care and hospital stays were also comparable.

Conclusions:

Endoscopic minimally invasive multiple-valve surgery is feasible, safe, and effective in select patients.
MIMVS presents a viable alternative to median sternotomy for multiple valve surgeries, with potential benefits in transfusion requirements.