Outcomes of minimally invasive versus conventional sternotomy for redo mitral valve surgery according to Mitral Valve Academic Research Consortium: A systematic review and meta-analysis

Dudy Arman Hanafy, Stefanie Melisa, Galih Asa Andrianto, Widya Trianita Suwatri, Sugisman

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)35-42
Number of pages8
JournalAsian Journal of Surgery
Volume47
Issue number1
DOIs
Publication statusPublished - Jan 2024

Keywords

  • Conventional sternotomy
  • Minimally invasive
  • Mitral Valve Academic Research Consortium
  • Redo mitral valve surgery

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