Related Experiment Video
Updated: May 31, 2026
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Safety and Learning Curve of Totally Endoscopic Mitral Valve Plasty: Initial 125 Cases Evaluated by Operative Time
Hidelazu Nakai1, Akitoshi Yamada1, Chihiro Okubo1
1Department of Cardiovascular Surgery, Kita-Harima Medical Center, Ono, Hyogo, Japan.
Innovations (Philadelphia, Pa.)
|May 30, 2026
Summary
Early totally endoscopic mitral valve plasty (TEMVP) shows a manageable learning curve and acceptable safety, even with complex cases. Operation time and risk-adjusted cumulative sum (RA-CUSUM) analysis confirm favorable outcomes during initial adoption.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Surgical Education
Background:
- Totally endoscopic mitral valve plasty (TEMVP) demands significant technical skill.
- Initial adoption phases may present challenges in achieving proficiency.
Purpose of the Study:
- To evaluate the learning curve for TEMVP.
- To assess perioperative outcomes during the early experience with TEMVP.
- To identify key metrics for evaluating TEMVP proficiency, including operation time and complication rates.
Main Methods:
- Retrospective analysis of 125 consecutive TEMVP patients (October 2021 - April 2025).
- Comparison of outcomes between a complex pathology group (n=40) and a control group (n=85).
- Learning curve assessment using operation time and risk-adjusted cumulative sum (RA-CUSUM) analysis based on the Japan Score.
Main Results:
- Complex cases had longer operative times (335 ± 71 min vs. 282 ± 61 min) and higher complication rates (17.5% vs. 3.5%).
- Two-year survival was 94.7% in the complex group versus 100% in the control group.
- Operation time decreased over time in overall and control groups, but not in the complex group; RA-CUSUM analysis indicated favorable trends.
Conclusions:
- Early TEMVP demonstrated favorable perioperative outcomes, even with complex patient profiles.
- The learning curve for TEMVP appears manageable, supported by operation time and RA-CUSUM analyses.
- TEMVP can be performed safely within acceptable limits during its initial adoption phase.
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