Long-Term Results of Minimally Invasive Mitral Valvuloplasty: Insights From a 12-Year Single-Center Experience

Purpose: The safety and long-term durability of minimally invasive mitral valvuloplasty (MIMVP) remain controversial. This study aimed to compare the perioperative and long-term outcomes of minimally invasive mitral valve surgery (MIMVS) and conventional sternotomy.Methods: This study included 476 patients who underwent mitral valve surgeries at our institution between January 2011 and December 2023. Patients were classified according to whether they underwent sternotomy: the nonsternotomy (NS: 271 cases) and sternotomy (S: 205 cases) groups. Perioperative and long-term outcomes were compared between the two groups.Results: The NS group had a lower preoperative age and EuroScore II. In the S group, the left ventricular ejection fraction was lower, while the left ventricular end-systolic diameter and left atrial diameter were larger. Operative time, cardiopulmonary bypass time, and aortic cross-clamp time were longer in the NS group. Postoperative atrial fibrillation, more transfusion, and increased length of hospital stay were more frequent in the S group. The 10-year freedom from reoperation and 10-year survival rates in the NS and S groups were 98.1% vs. 93.6% (p = 0.07) and 94.8% vs. 86.9%, respectively (p = 0.08), with no significant differences.Conclusion: MIMVP demonstrates noninferior perioperative and long-term outcomes compared with conventional sternotomy.