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Updated: Aug 5, 2026
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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Transition from Direct-View to Totally Endoscopic Mitral Valve Surgery in an Experienced Minimally Invasive Center: A
Andrzej Klapkowski1, Aleksandra Stańska2, Igor Tomczyk1
1Department of Cardiac Surgery, Faculty of Medicine, Medical University of Gdansk, ul. Skłodowskiej-Curie 3A, 80-210 Gdańsk, Poland.
Life (Basel, Switzerland)
|July 28, 2026
Summary
Transitioning to totally endoscopic mitral valve surgery significantly reduced cardiopulmonary bypass and aortic cross-clamp times. This minimally invasive approach maintained comparable early postoperative outcomes, indicating its safety and efficiency in experienced centers.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Surgical Innovation
Background:
- Totally endoscopic mitral valve surgery is an evolving minimally invasive cardiac surgery technique.
- Concerns exist regarding the implementation, safety, and efficiency of endoscopic mitral valve procedures.
- This study evaluates the early experience of transitioning to a totally endoscopic approach from direct-view minimally invasive surgery.
Purpose of the Study:
- To assess the safety and efficiency of adopting totally endoscopic mitral valve surgery.
- To compare operative times and early postoperative outcomes between totally endoscopic and direct-view minimally invasive mitral surgery.
- To evaluate the learning curve and feasibility of endoscopic mitral valve repair/replacement in an experienced center.
Main Methods:
- Retrospective analysis of 209 patients undergoing minimally invasive mitral valve surgery.
- Comparison of 36 totally endoscopic cases with 173 direct-view minimally invasive cases.
- Propensity score matching based on age, LVEF, and NYHA class to create 36 matched pairs for analysis.
Main Results:
- Endoscopic cohort showed significantly shorter cardiopulmonary bypass (120.4 vs. 153.1 min) and aortic cross-clamp times (77.1 vs. 97.8 min).
- Postoperative outcomes, including atrial fibrillation incidence and transfusion rates, were comparable between groups.
- Procedural success was high in both groups (100% endoscopic vs. 94.4% direct-view).
Conclusions:
- Transition to totally endoscopic mitral valve surgery is safe and efficient in experienced centers.
- The endoscopic approach offers reduced operative times without compromising early patient outcomes.
- Further multicenter studies are needed to confirm these findings and explore long-term benefits.
