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Minimally Invasive Mitral Valve Surgery Compared to Sternotomy in Patients Over 70 Years Old: A Retrospective

Andrew Tjon Joek Tjien1, Kinsing Ko2,3, Samuel Heuts4,5

  • 1Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, 5623 EJ, The Netherlands.

Interdisciplinary Cardiovascular and Thoracic Surgery
|January 28, 2026
PubMed
Abstract

Insights

Minimally invasive mitral valve surgery (MIMVS) in patients over 70 shows lower 30-day mortality and fewer complications compared to traditional median sternotomy (MST). Mid-term survival rates were similar between both surgical approaches.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Medicine
  • Minimally Invasive Procedures

Background:

  • Elderly patients face higher risks of morbidity and mortality after mitral valve surgery.
  • Minimally invasive mitral valve surgery (MIMVS) is gaining popularity, with potential advantages for older adults.

Purpose of the Study:

  • To compare short- and mid-term outcomes of MIMVS versus median sternotomy (MST) in patients aged 70 and above.
  • To evaluate the safety and efficacy of MIMVS in the elderly population.

Main Methods:

  • A nationwide registry study included patients over 70 undergoing primary elective mitral valve surgery between 2013-2021.
  • Data were extracted from the Netherlands Heart Registration, focusing on short-term morbidity, mortality, and 5-year survival.

Main Results:

  • MIMVS was associated with significantly lower 30-day mortality (0.6% vs. 2.5%) compared to MST.
  • Postoperative complications, including pneumonia, prolonged intubation, ICU readmission, kidney failure, and new-onset arrhythmias, were less frequent with MIMVS.
  • No significant difference in 5-year survival was observed between the MIMVS and MST groups.

Conclusions:

  • MIMVS in patients over 70 years old may offer reduced 30-day mortality and fewer postoperative complications compared to sternotomy.
  • The study suggests MIMVS is a safe and effective alternative for elderly patients undergoing mitral valve surgery.
Keywords:
minimally invasive mitral valve surgerymitral valve surgerynationwide registrypatients over 70 years old

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