Lower Ministernotomy: An Approach for Treating All Valvulopathies?

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Valvular Heart Disease

Background:

• Lower ministernotomy provides superior visualization of all four cardiac chambers.
• This approach facilitates surgical treatment for aortic, mitral, and tricuspid valve diseases, as well as intracardiac procedures.
• Limited data exists on the technical aspects, safety, and echocardiographic outcomes of lower ministernotomy.

Purpose of the Study:

• To evaluate the outcomes of lower ministernotomy in patients undergoing valvulopathy treatment.
• To assess the safety and efficacy of lower ministernotomy for other intracardiac surgical procedures.

Main Methods:

• Retrospective study including adult patients (over 18 years) undergoing cardiac surgery via lower ministernotomy.
• Data collected from January 2017 to March 2023 at Pitié-Salpêtrière Hospital, Paris.
• Key outcome variables included all-cause mortality, postoperative complications, and echocardiographic results.

Main Results:

• 633 patients underwent lower ministernotomy for aortic valve surgery (338), mitral valve surgery (254), combined valve surgery (25), or other intracardiac procedures (38).
• Hospital survival rates ranged from 96% to 99.1% across different surgical groups.
• Low rates of complications were observed: 2.1% mediastinitis, 1.7% permanent stroke, and 7.5% new pacemaker implantation.

Conclusions:

• Lower ministernotomy is a safe and effective surgical approach for treating valvulopathies and other intracardiac diseases.
• The procedure is associated with low rates of morbidity and mortality.
• This technique is suitable for isolated or combined valve surgeries and other intracardiac interventions.