Valvular & structural heart diseaseResearch article
Evolution of endoscopic mitral valve surgery over a 11-year period at a high-volume center
- Data was retrospectively analyzed
- consecutive patients
- high-volume center
Authors' conclusion
In the present analysis, evolution of endoscopic MVS from isolated procedures in young, low-risk patients with simple MV pathology to combined procedures in older patients with complex MV disease, was demonstrated. Despite increasing surgical risk, complexity of MV disease as well as an increasing rate of concomitant procedures, perioperative outcome remained favorable over time, resulting in promising mid- to long-term results.
Study context
- Population
- Patients undergoing endoscopic mitral valve surgery at a single institution, 2012–2022consecutive patients who underwent endoscopic mitral valve surgery (MVS) · initial-group (2012-2017) 487 · late-group (2018-2022) 550
- Participants
- 1.037 patients
- Comparison
- initial- vs late-group
- initial-groupn = 487
- late-groupn = 550
Main finding
As reported in the abstract
- Patient age increased during the study period
- P for trend = 0.0275
Further findings
Prevalence of coronary artery disease
Prevalence of endocarditis
Median
| Outcome | initial-group | late-group |
|---|---|---|
| Median STS PROM score | 0.3 (range as printed 0.3–0.5) | 0.4 (range as printed 0.3–0.9) |
- Prevalence of coronary artery disease — P
- P < .001
- Prevalence of endocarditis — P
- P = .0026
- Median STS PROM score — increased
- p trend < 0.001
MV repair
- MV repair was performed
- 92.7%
Concomitant procedures
- closure of left atrial appendage
- 21.0%
- atrial ablation
- 19.2%
- tricuspid valve repair
- 6.7%
- increased significantly over time
- P for trend < 0.01
Median bypass and cross-clamp times
- decreased
- P for trend < 0.001
Median postoperative ventilation time
- Median postoperative ventilation time (hours)
- 5.0 (3.3-7.0)
- decreased during the study-period
- P for trend < 0.001
Length of intensive care unit and in-hospital stay
- intensive care unit stay (days)
- 2.0 (1.0-3.0)
- in-hospital stay (days)
- 7.0 (6.0-9.0)
Overall mortality · 30 days
- overall mortality excluding patients with endocarditis
- 0.6%
Re-operation rate and overall survival · 5 years
- re-operation rate
- 2.5%
- overall survival
- 94.0%
Reoperation rate and overall survival · maximum follow up of 11.2 years
- reoperation rate
- 5.0%
- overall survival
- 88.5%
Original publication
Summarised from the published abstract; every number is checked against it