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Minimally Invasive Surgery for Mitral Valve Endocarditis: A Systematic Review and Meta-Analysis of Reconstructed
Thomas Karagkounis1, Angeliki Alifragki2, Ioannis Zoupas3
14th Department of Cardiac Surgery, Hygeia Hospital, 15123 Athens, Greece.
Journal of Personalized Medicine
|July 27, 2026
Summary
Minimally invasive surgery for mitral valve infective endocarditis offers favorable outcomes, comparable survival to sternotomy, and shorter ICU stays. This approach may be a viable option for select patients.
Area of Science:
- Cardiovascular Surgery
- Infective Diseases
- Minimally Invasive Procedures
Background:
- Minimally invasive (MIS) mitral valve surgery is a safe alternative to sternotomy (ST) with better recovery.
- The efficacy of MIS for mitral valve infective endocarditis (IE) is not well-established.
- This meta-analysis evaluates MIS outcomes for mitral valve IE.
Purpose of the Study:
- To assess the safety and effectiveness of MIS for mitral valve IE.
- To compare MIS outcomes with traditional sternotomy (ST) for mitral valve IE.
- To analyze early and long-term survival and reoperation rates for MIS in mitral valve IE.
Main Methods:
- PRISMA-compliant literature search of PubMed, Scopus, and Cochrane databases.
- Analysis of 14 retrospective studies involving 949 patients with mitral valve IE.
- Reconstruction of time-to-event data from Kaplan-Meier curves and comparative analysis between MIS and ST.
Main Results:
- Early mortality in the MIS cohort was 4.2%.
- 1, 5, and 10-year overall survival rates were 86.7%, 75.2%, and 56.2%, respectively.
- MIS showed comparable survival to ST, with significantly shorter ICU stays (p < 0.01).
Conclusions:
- MIS for mitral valve IE demonstrates favorable early and long-term results.
- MIS offers survival rates comparable to sternotomy and reduces intensive care unit (ICU) stay.
- MIS is a feasible and potentially effective alternative for carefully selected mitral valve IE patients.
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