Original articleAdult cardiacThoracoscopic Versus Open Mitral Valve Repair: A Propensity Score Analysis of Early Outcomes
Section snippets
Material and Methods
This study involved a retrospective review of the medical records of patients undergoing primary MV repair for MR due to leaflet prolapse through median sternotomy (open) at the Mayo Clinic, Rochester, Minnesota (H.V.S.), or thoracoscopically through a port-access approach (port) at the University of Pennsylvania Hospitals, Philadelphia, Pennsylvania (W.C.H.). The study was approved by the Institutional Review Board of both institutions, which waived the need for patient consent for the study.
Results
Baseline preoperative characteristics were compared between the two groups (Table 1). Port patients were more frequently female (148 [42%] versus 119 [33%], p = 0.007), and had a higher likelihood of having NYHA class III or IV symptoms (100 [29%] versus 48 [13%], p < 0.001), diabetes mellitus (19 [5%] versus 8 [2%], p = 0.023), congestive heart failure (90 [26%] versus 26 [7%], p < 0.001), and a lower EF (53% versus 64%, p < 0.001). Among port patients, 68% had posterior leaflet prolapse; 12%
Comment
The early safety and long-term durability of MV repair for mitral leaflet prolapse performed through median sternotomy have both been clearly established in the literature [2, 3, 10, 11, 12]. It is well understood that the referral of asymptomatic patients for early MV repair minimizes postoperative symptoms, while improving life expectancy and long-term recovery of EF. Minimally invasive approaches to MV repair have recently evolved and have rapidly proliferated largely in the absence of
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