Evidence map›Paper›PMID 38263168›Full record

ArticleJournal of cardiothoracic surgery2024

Navigating the challenges of minimally invasive mitral valve surgery: a risk analysis and learning curve evaluation.

Nestoras Papadopoulos, Vasileios Ntinopoulos, Stak Dushaj, Achim Häussler, Dragan Odavic, Hector Rodríguez Cetina Biefer, Omer Dzemali

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiothoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Roving pen: minimally invasive mitral surgery.Indian journal of thoracic and cardiovascular surgery · 2025
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Nestoras PapadopoulosDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland. nestoras.papadopoulos@stadtspital.ch.
Vasileios NtinopoulosDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
Stak DushajDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
Achim HäusslerDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
Dragan OdavicDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
Hector Rodríguez Cetina BieferDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
Omer DzemaliDepartment of Cardiac Surgery, City Hospital, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
University Hospital of Zurich · CHStadtspital Waid · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to report the risk and learning curve analysis of a minimally invasive mitral valve surgery program performed through a right mini-thoracotomy at a single institution.

methodsFrom January 2013 through December 2019, 266 consecutive patients underwent minimally invasive mitral valve surgery in our department and were included in the current study. Multiple logistic regression analysis was used for the adverse event outcome. Distribution over time of perioperative complications, defined as clinical endpoints in the Valve Academic Research Consortium-2 (VARC-2) consensus document, as well as CUSUM charts for assessment of cardiopulmonary bypass and aortic cross-clamping duration over time, has been performed for learning curve assessment.

resultsOverall incidences of postoperative stroke (1.1%), myocardial infarction (1.1%), and thirty-day mortality (1.5%) were low. The mitral valve reconstruction rate in our series was 95%. Multivariable analysis revealed that concomitant tricuspid valve surgery (OR 4.44; 95%CI 1.61-11.80; p = 0.003) was significantly associated with adverse event outcomes. Despite a trend towards adverse event outcomes in patients with preexisting active mitral valve endocarditis (OR 2.69; 95%CI 0.81-7.87; p = 0.082), mitral valve pathology did not significantly impact postoperative morbidity and mortality. Distribution over time of perioperative complications, defined as clinical endpoints in the VARC-2 consensus document, showed a trend towards an improved complication rate after the initial 65-100 procedures.

conclusionsMitral valve surgery via right-sided mini-thoracotomy can be implemented safely with low perioperative morbidity and mortality rates. Careful patient selection regarding isolated mitral valve surgery in the presence of degenerative mitral valve disease may represent a significant safety issue during the learning curve.

trial registrationThe cantonal ethics commission of Zurich approved the study (registration ID 2020-00752, date of approval 24 April 2020).

Indexed as

Cardiac Surgical ProceduresMyocardial InfarctionHumansLearning CurveMitral ValveRisk AssessmentMinimally invasive cardiac surgeryMitral valve reconstructionMitral valve surgerySurgical education

Identifiers

PMID38263168
PMCPMC10807125
OpenAlexW4391132493

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.