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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
PubMed

Insights

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.
Keywords:
infective endocarditisminimally invasive surgerymitraloverall survival

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