Minimally Invasive versus Conventional Open Mitral Valve Surgery a Meta-Analysis and Systematic Review

2011 ◽  
Vol 6 (2) ◽  
pp. 84-103 ◽  
Author(s):  
Davy C. H. Cheng ◽  
Janet Martin ◽  
Avtar Lal ◽  
Anno Diegeler ◽  
Thierry A. Folliguet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery

scholarly journals Transthoracic clamp versus endoaortic balloon occlusion in minimally invasive mitral valve surgery: a systematic review and meta-analysis

2019 ◽  
Vol 56 (4) ◽  
pp. 643-653 ◽  
Author(s):  
Paul Martin Rival ◽  
Theresa H M Moore ◽  
Alexandra McAleenan ◽  
Hamish Hamilton ◽  
Zachary Du Toit ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Cerebrovascular Accident ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Balloon Occlusion ◽  
Valve Surgery ◽  
Risk Of Bias ◽  
Aortic Cannulation

Summary This systematic review and meta-analysis aims to determine outcomes following aortic occlusion with the transthoracic clamp (TTC) versus endoaortic balloon occlusion (EABO) in patients undergoing minimally invasive mitral valve surgery. A subgroup analysis compares TTC to EABO with femoral cannulation separately from EABO with aortic cannulation. We searched Medline and Embase up to December 2018. Two people independently and in duplicate screened title and abstracts, full-text reports, extracted data and assessed the risk of bias using the Cochrane risk-of-bias tool for non-randomized studies. We identified 1564 reports from which 11 observational studies with 4181 participants met the inclusion criteria. We found no evidence of difference in the risk of postoperative death or cerebrovascular accident (CVA) between the 2 techniques. Evidence for a reduction in aortic dissection with TTC was found: 4 of 1590 for the TTC group vs 19 of 2492 for the EABO group [risk ratio 0.33, 95% confidence interval (CI) 0.12–0.93; P = 0.04]. There was no difference in aortic cross-clamp (AoX) time between TTC and EABO [mean difference (MD) −5.17 min, 95% CI −12.40 to 2.06; P = 0.16]. TTC was associated with a shorter AoX time compared to EABO with femoral cannulation (MD −9.26 min, 95% CI −17.00 to −1.52; P = 0.02). EABO with aortic cannulation was associated with a shorter AoX time compared to TTC (MD 7.77 min, 95% CI 3.29–12.26; P < 0.001). There was no difference in cardiopulmonary bypass (CPB) time between TTC and EABO with aortic cannulation (MD −4.98 min, 95% CI −14.41 to 4.45; P = 0.3). TTC was associated with a shorter CPB time compared to EABO with femoral cannulation (MD −10.08 min, 95% CI −19.93 to −0.22; P = 0.05). Despite a higher risk of aortic dissection with EABO, the rates of survival and cerebrovascular accident across the 2 techniques are similar in minimally invasive mitral valve surgery.

scholarly journals Minimally Invasive Versus Sternotomy for Mitral Surgery in the Elderly: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 155698452110003
Author(s):  
Ali Hage ◽  
Fadi Hage ◽  
Hussein Al-Amodi ◽  
Suruchi Gupta ◽  
Stefania I. Papatheodorou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Elderly Patients ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Blood Product Transfusion ◽  
Cochrane Central Register

Objective The safety of minimally invasive mitral valve surgery (MIMVS) in elderly patients is still debated. Our objective was to perform a systematic review and meta-analysis of studies comparing MIMVS with conventional sternotomy (CS) in elderly patients (≥65 years old). Methods We searched PubMed, EMBASE, Web of Science, clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for trials and observational studies comparing MIMVS with CS in patients ≥65 years old presenting for mitral valve surgery. We performed a random-effects meta-analysis of all outcomes. Results The MIMVS group had lower odds of acute renal failure (odds ratio [OR] 0.27; 95% CI 0.10 to 0.78), prolonged intubation (>48 h; OR 0.47; 95% CI 0.31 to 0.70), less blood product transfusion (weighted mean difference [WMD] −0.82 units; 95% CI −1.29 to −0.34 units), shorter ICU length of stay (LOS; WMD −2.57 days; 95% CI −3.24 to −1.90 days) and hospital LOS (WMD −4.06 days; 95% CI −5.19 to −2.94 days). There were no significant differences in the odds of mortality, stroke, respiratory infection, reoperation for bleeding, and postoperative atrial fibrillation. MIMVS was associated with longer cross-clamp (WMD 11.8 min; 95% CI 3.5 to 20.1 min) and cardiopulmonary bypass times (WMD 23.0 min; 95% CI 10.4 to 35.6 min). Conclusions MIMVS in elderly patients is associated with lower postoperative complications, blood transfusion, shorter ICU, and hospital LOS, and longer cross-clamp and bypass times.

Mitral valve surgery; Right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
S.H. Sündermann ◽  
J. Sromicki ◽  
H. Rodriguez Cetina Biefer ◽  
M.Y. Emmert ◽  
B. Seifert ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery

A Systematic Review and Meta-analysis of Transeptal vs Left Atrial Approach for Mitral Valve Surgery

2020 ◽  
Vol 4 (sup1) ◽  
pp. 121-122
Author(s):  
Amer Harky ◽  
Arish Noshirwani ◽  
Dimitrios Pousios ◽  
Andrew D. Muir
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Left Atrial ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery

Left Atrial or Transeptal Approach for Mitral Valve Surgery: A Systematic Review and Meta-analysis

2020 ◽  
pp. 100602
Author(s):  
Amer Harky ◽  
Ter-Er Kusu-Orkar ◽  
Jeffrey Shi Kai Chan ◽  
Arish Noshirwani ◽  
Sugeevan Savarimuthu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Left Atrial ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery

scholarly journals Minimally Invasive versus Conventional Approach for Mitral Valve Surgery

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A B ElKerdany ◽  
M A Elghanam ◽  
M A Gamal ◽  
T M E Abdelmoneim
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Mitral Valve Disease ◽  
Meta Analysis ◽  
Median Sternotomy ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Valve Disease ◽  
Standard Approach ◽  
Perioperative Outcomes

Abstract Introduction Full median sternotomy has been well established as a standard approach for all types of open heart surgery for many years. Although well established, the full sternotomy incision has been frequently criticized for its length, post operative pain and possible complications. Minimally invasive mitral valve surgery can be an appealing feasible alternative to the conventional full sternotomy approach with low perioperative morbidity and short-term mortality. We here made meta-analysis to compare perioperative outcomes of MIMVS versus CMVS in patients with mitral valve disease. Methods A systematic review of studies comparing perioperative outcomes of MIMVS versus CMVS in patients with mitral valve disease, from 2012 up to 2017. Review Manager 5.2 (Cochrane Collaboration) was employed to analyze the results. The outcomes of interest are mortality, cerebrovascular accidents, wound infection, reexploration due to bleeding, and LVEF assessment post-surgery. Results 12 studies involving 10279 patients were included in the meta-analysis. The 30-day mortality was significantly decreased with MIMVS; 1.6% in the MIMVS group and 2.9% in the group treated through a conventional sternotomy. Cerebrovascular events were significantly decreased with MIMVS; the stroke rate was 0.9% in MIMVS patients and 3% in patients treated via a conventional sternotomy. Wound infections, reexploration due to bleeding, and LVEF did not differ significantly between both groups. Conclusion The perioperative outcome is more or less similar for minimally invasive mitral valve surgery and conventional mitral valve surgery performed via median sternotomy. Given balance in outcomes, MIMVS is at least as safe as the standard approach and can be considered a routine and standard approach for mitral valve surgery.

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