Analysis of clinical outcome and postoperative organ function effects in a propensity‐matched comparison between conventional and minimally invasive mitral valve surgery

• DOI: 10.1111/jocs.15010
• Publication Date: 2020-09-14T07:50:48Z
• Authors: Sophie Missault; Jérôme Van Causen...; Korneel Vandewiele; Jens Czapla; Tine Philipsen; Katrien François; Thierry Bové
• Keywords: Median sternotomy

Background Minimally invasive mitral valve (MV) surgery (MIVT) is increasingly performed with excellent clinical outcome, despite longer procedural times. This study analyzes outcomes and effects on secondary organ functions in a propensity-matched comparison conventional MV surgery. Methods Results Out of 439 patients undergoing from January 2005 to May 2017, 233 were included after propensity-matching: 90 sternotomy 143 MIVT patients. Endpoints focused survival, quality repair, function through analysis biomarkers functional parameters. Regardless cardiopulmonary bypass (sternotomy: 101(IQR33) min—MIVT:143(IQR45) min, p < .001) cardioplegic arrest times(sternotomy: 64(IQR25) min—MIVT:90(IQR34) .001), no differences survival nor complication rate found. Effect renal function(creatinine, = .751 – ureum, .538 glomerular filtration, .848), myocardial damage by troponine I level (sternotomy:1.8 ± 3.9 ng/ml MIVT:1.2 1.3 ng/ml, .438) prolonged ventilatory support >24 h (sternotomy:5.5% MIVT:8.4%, .417) comparable. The systemic inflammatory reaction postoperative C-reactive protein count was markedly lower for MIVT(p .001). Increased rhadomyolysis found surgery, based significant elevation creatinine-kinase levels(sternotomy: 431 237 U/L MIVT: 701 595 U/L, Conclusion Despite an inherent learning curve, minimally guarantees outcome repair quality, at least non-inferior those via sternotomy. Notwithstanding cardiac times, the impact negligible, except response. increase CK-enzymes suggestive enhanced rhabdomyolysis needs be accounted when times tend exceed critical time threshold severe limb ischemia.