Objectives: To compare the long term outcomes between minimally invasive\nmitral valve repair (MiMVR) and conventional surgery. Current retrospective\ncomparisons between the techniques frequently report echocardiographical\n(echo) outcomes early after surgery and rarely report them later. Methods:\nPatients were selected for MiMVR by the surgical multi-disciplinary meeting\nfrom June 2008-March 2013. Patients included had at least two transthoracic\npost-operative echocardiograms. Echocardiographic parameters including left\nventricular size and systolic function, degree of mitral regurgitation (MR) and\nmean mitral valve gradient were recorded. Clinical outcomes including\nall-cause mortality, re-operation, recurrence of at least moderate MR and\nelevated mean mitral valve gradients > 5 mmHg were recorded and compared\nusing Kaplan-Meier survival analysis. Results: 223 patients were screened, 96\n(43%) met the criteria and were included. Thirty-seven patients underwent\nconventional surgery and 59 underwent MiMVR. Mean clinical follow-up\nwas 6.3 years and echo follow up was 3.2 years. There was a significantly\nhigher recurrence of moderate MR in the conventional group (38% (n = 19)\nversus 17% (n = 10)). The mean LV end-diastolic diameter was 4.8 cm (conventional)\nversus 5.0 cm (MiMVR). The incidence of elevated PG was 26% (n\n= 13, conventional) and 23% (n = 14, MiMVR). There was no significant difference\nin incidence in re-operation (conventional 12% (n = 6), MiMVR 8.3% (n =\n5)). Long-term mortality was higher in the conventional group (1.7% vs. 18%\np = 0.004) although the logistic Euroscore was significantly higher 6.8% ± 5.4\nvs. 3.6% ± 1.6. Conclusions: Minimally invasive mitral valve surgery is safe\nand feasible in selected patients with good medium and long-term echocar diographic follow-up.
Loading....