Comparative study between mitral valve surgery by the minimally invasive approach and traditional median sternotomy

Background
This study compares our experience of early surgical outcome for the mitral valve (MV) after minimally invasive surgery and traditional median sternotomy approach.
Aim
The aim of the study is to evaluate early surgical outcome of minimally invasive mitral valve surgery (MIMVS) in our experience.
Patients and methods
It is a prospective comparative cohort study in adult patients who perform MVS either MI or standard median sternotomy (SMS). From January 2019 to December 2021, early outcome of MVS between (120 patients) MI group through right minithoracotomy with cardiopulmonary bypass peripheral cannulation and 120 patients SMS group are compared.
Result
Females are more in MIMVS (80%). Blood loss is lesser in MIMVS (250 ± 60.6 ml) than in SMS (550 ± 230 ml). Blood transfusion required 0.1 ± 0.53 in MIMVS, and 0.9 ± 0.7 in SMS. Reexploration for bleeding is required in four cases of SMS. Mechanical ventilation time is shorter in MIMVS (6.4 ± 1.3) than in SMS (12.4 ± 6.8). ICU duration and hospital stay are shorter in MIMVS than SMS (2 ± 0.4 vs. 3.5 ± 1.3, 7.2 ± 1.3 vs. 12 ± 0.5). Wound infections were present in 20 cases of SMS. Spirometric studies in MIMVS reveal better postoperative pulmonary functions than the SMS group. Pain visual analog score at discharge is better in MIMVS (1.4 ± 0.6) than in SMS (8.5 ± 1.5).
Conclusion
Minimally invasive surgery for the MV showed satisfactory outcome in comparison to sternotomy approach. The need for rising curve of training for all surgeons is mandatory.