ArticleJournal of cardiothoracic surgery2021
Minimally invasive or sternotomy approach in mitral valve surgery: a propensity-matched comparison.
Article in Journal of cardiothoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Minimally Invasive or Conventional Sternotomy for Mitral Valve Surgery With Concomitant Surgical Ablation for Atrial Fibrillation: A Comparative Systematic Review.Reviews in cardiovascular medicine · 2025Pooled it
- Minithoracotomy versus sternotomy in mitral valve surgery: meta-analysis from recent matched and randomized studies.Journal of cardiothoracic surgery · 2023Pooled it
- Axillary Versus Sternotomy Access in Minimally Invasive Mitral Valve Surgery: A Systematic Review and Meta-Analysis.Innovations (Philadelphia, Pa.)Pooled it
- Conventional Versus Minimally Invasive Mitral Valve Replacement: A Retrospective Comparison of Sternotomy, Mini-Thoracotomy, and Periareolar Approaches.Journal of clinical medicine · 2026Article
- Comparative outcomes of totally endoscopic versus direct vision mini-thoracotomy mitral valve repair: A propensity score-matched retrospective analysis.JTCVS open · 2026Article
- Perioperative management of a patient with comorbid immune thrombocytopenia and antiphospholipid syndrome undergoing minimally invasive mitral valve surgery.Journal of cardiothoracic surgery · 2026Article
- Custodiol Versus Del Nido Cardioplegia in Minimally Invasive Mitral Valve Repair-a Propensity Score-Matched Study.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Minimally invasive mitral valve surgery in a middle-income country: feasibility and learning curve in a low-volume center.Journal of cardiothoracic surgery · 2026Article
- Advancing Minimally Invasive Mitral Valve Surgery: Early Outcomes of a Total Endoscopic 2D and 3D Approach.Journal of cardiovascular development and disease · 2025Article
- Article
- Minimally Invasive Surgery through Right Mini-Thoracotomy for Mitral Valve Infective Endocarditis: Contraindicated or Safely Possible?Journal of clinical medicine · 2024Article
- Pushing boundaries in cardiac surgery: minimally invasive mitral valve repair combined with tricuspid valve repair and/or other concomitant procedures.Frontiers in cardiovascular medicine · 2024Article
- An international survey-based assessment of minimally invasive mitral valve surgery.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Minimally invasive approach associated with lower resource utilization after aortic and mitral valve surgery.JTCVS open · 2023Article
- Safety and Efficacy of the Transaxillary Access for Minimally Invasive Mitral Valve Surgery-A Propensity Matched Competitive Analysis.Medicina (Kaunas, Lithuania) · 2022Article
- State-of-the-Art Review: Technical and Imaging Considerations in Novel Transapical and Port-Access Mitral Valve Chordal Repair for Degenerative Mitral Regurgitation.Frontiers in cardiovascular medicine · 2022Review
- The Impact of Biomedical Engineering on the Development of Minimally Invasive Cardio-Thoracic Surgery.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesConventional mitral valve surgery through median sternotomy improves long-term survival with acceptable morbidity and mortality. However, less-invasive approaches to mitral valve surgery are now increasingly employed. Whether minimally invasive mitral valve surgery is superior to conventional surgery is uncertain.
methodsA retrospective analysis of patients who underwent mitral valve surgery via minithoracotomy or median sternotomy between 2012 and 2018. A propensity score-matched analysis was generated to eliminate differences in relevant preoperative risk factors between the two groups.
resultsData from 525 patients were evaluated, 189 underwent minithoracotomy and 336 underwent median sternotomy. The 30 day mortality was similar between the minithoracotomy and conventional surgery groups (1 and 3%, respectively; p = 0.25). No differences were seen in the incidence of stroke (p = 1.00), surgical site infections (p = 0.09), or myocardial infarction (p = 0.23), or in total hospital cost (p = 0.48). However, the minimally invasive approach was associated with fewer patients receiving transfusions (59% versus 76% in the conventional group; p = 0.001) or requiring reoperation for bleeding (3% versus 9%, respectively; p = 0.03). There were no significant differences in 5 year survival between the minithoracotomy and conventional surgery groups (93% versus 86%, respectively; p = 0.21) and freedom from mitral valve reoperation (95% versus 94%, respectively; p = 0.79).
conclusionsIn patients undergoing mitral valve surgery, a minimally invasive approach is feasible, safe, and reproducible with excellent short-term outcomes; mid-term outcomes and efficacy were also seen to be comparable to conventional sternotomy.
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