TY - JOUR
T1 - Outcomes of minimally invasive versus conventional sternotomy for redo mitral valve surgery according to Mitral Valve Academic Research Consortium
T2 - A systematic review and meta-analysis
AU - Hanafy, Dudy Arman
AU - Melisa, Stefanie
AU - Andrianto, Galih Asa
AU - Suwatri, Widya Trianita
AU - Sugisman,
N1 - Publisher Copyright:
© 2023 Asian Surgical Association and Taiwan Robotic Surgery Association
PY - 2024/1
Y1 - 2024/1
N2 - A minimally invasive approach through right mini-thoracotomy for redo mitral valve surgery may improve patients’ outcomes compared to median sternotomy. This study aims to evaluate the outcomes of both procedures according to the Mitral Valve Academic Research Consortium (MVARC). This systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Literature searching was performed in several databases including PubMed, EBSCOhost, Scopus, and Proquest up to 28 February 2022. Meta-analysis using proportions or means was applied. A total of 13 retrospective cohort articles were included in this study. The incidence of in-hospital mortality (3% vs 9.2%, OR = 0.35; 95% CI: 0.21–0.58; P ≤ 0.0001), reintervention for bleeding (3.8% vs 5.9%, OR = 0.56; 95% CI: 0.32–0.97; P = 0.04), and acute renal failure (5% vs 12%, OR = 0.29; 95% CI: 0.23–0.65; P = 0.0003) was significantly lower in mini-thoracotomy (MINI) group compared to median sternotomy (STER) group. The incidence of neurologic events (3.4% vs 5.5%, OR = 0.66; 95% CI: 0.4–1.08; P = 0.1) and arrhythmia (19.5% vs 25.5%, OR = 0.64; 95% CI: 0.38–1.09; P = 0.1) were also lower in MINI group compared to STER group but was not significant statistically. No significant differences were found in myocardial infarct (1% vs 1%, OR = 0.71; 95% CI: 0.06–8.85; P = 0.79) between MINI and STER group. A minimally invasive surgery through right mini-thoracotomy is associated with a lower incidence of in-hospital mortality, reintervention for bleeding, and acute renal failure. It is a safe alternative to median sternotomy for redo mitral valve surgery.
AB - A minimally invasive approach through right mini-thoracotomy for redo mitral valve surgery may improve patients’ outcomes compared to median sternotomy. This study aims to evaluate the outcomes of both procedures according to the Mitral Valve Academic Research Consortium (MVARC). This systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Literature searching was performed in several databases including PubMed, EBSCOhost, Scopus, and Proquest up to 28 February 2022. Meta-analysis using proportions or means was applied. A total of 13 retrospective cohort articles were included in this study. The incidence of in-hospital mortality (3% vs 9.2%, OR = 0.35; 95% CI: 0.21–0.58; P ≤ 0.0001), reintervention for bleeding (3.8% vs 5.9%, OR = 0.56; 95% CI: 0.32–0.97; P = 0.04), and acute renal failure (5% vs 12%, OR = 0.29; 95% CI: 0.23–0.65; P = 0.0003) was significantly lower in mini-thoracotomy (MINI) group compared to median sternotomy (STER) group. The incidence of neurologic events (3.4% vs 5.5%, OR = 0.66; 95% CI: 0.4–1.08; P = 0.1) and arrhythmia (19.5% vs 25.5%, OR = 0.64; 95% CI: 0.38–1.09; P = 0.1) were also lower in MINI group compared to STER group but was not significant statistically. No significant differences were found in myocardial infarct (1% vs 1%, OR = 0.71; 95% CI: 0.06–8.85; P = 0.79) between MINI and STER group. A minimally invasive surgery through right mini-thoracotomy is associated with a lower incidence of in-hospital mortality, reintervention for bleeding, and acute renal failure. It is a safe alternative to median sternotomy for redo mitral valve surgery.
KW - Conventional sternotomy
KW - Minimally invasive
KW - Mitral Valve Academic Research Consortium
KW - Redo mitral valve surgery
UR - http://www.scopus.com/inward/record.url?scp=85170574326&partnerID=8YFLogxK
U2 - 10.1016/j.asjsur.2023.09.001
DO - 10.1016/j.asjsur.2023.09.001
M3 - Review article
AN - SCOPUS:85170574326
SN - 1015-9584
VL - 47
SP - 35
EP - 42
JO - Asian Journal of Surgery
JF - Asian Journal of Surgery
IS - 1
ER -