ArticleThe Annals of thoracic surgery2025
Minimally Invasive Valve Surgery for Patients With Infective Endocarditis: A Comparative Study.
Article in The Annals of thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Minimally Invasive Surgery for Mitral Valve Endocarditis: A Systematic Review and Meta-Analysis of Reconstructed Time-to-Event Data.Journal of personalized medicine · 2026Review
- Robotic degenerative mitral valve repair: an evolution.Annals of cardiothoracic surgery · 2026Review
- Minimally Invasive Mitral Valve Surgery in Patients Aged ≥75 Years: An Expanding Standard of Care.Journal of clinical medicine · 2025Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundPatients with endocarditis frequently require valve surgical procedure, and despite the recent growth of minimally invasive cardiac surgery (MICS) for complex valve operations, consensus recommendations still suggest conventional sternotomy.
methodsThe institutional Adult Cardiac Surgery Database of The Society of Thoracic Surgeons (STS) evaluated all patients undergoing valve surgical procedure for endocarditis from July 2016 to March 2024. Patients were stratified by conventional sternotomy vs an MICS approach, including hemisternotomy, right thoracotomy, and robotic-assisted mitral, tricuspid, or aortic valve surgical procedure. Logistic regression assessed the risk-adjusted association with the primary outcomes of STS major morbidity or mortality and the MICS approach by accounting for all covariates in current STS risk models.
resultsOf 741 patients undergoing valve surgical procedure for endocarditis, the median age was 37 years, 582 (78.5%) had a substance use disorder, 210 (28.3%) underwent redo sternotomies, and 166 (22.4%) had redo valve operations. MICS was associated with a higher repair rate for mitral valves (76.3% vs 48%; P < .0001) but a lower rate for tricuspid valve (22.5% vs 44.1%; P < .0001), with no difference for aortic valves (8.3% vs 7.4%; P = .372). Before risk adjustment, MICS was associated with longer cross-clamp times (99 minutes vs 86 minutes; P = 0.019) but a lower incidence of STS major morbidity or mortality (15.4% vs 27.8%; P = 0.019). After robust risk adjustment, age (odds ratio [OR], 1.1; P = 0.008), lung disease (OR, 2.2; P = 0.010), preoperative creatinine (OR, 1.3; P = 0.016), and valve repair vs replacement (OR, 0.17; P = 0.002), but not MICS (OR, 1.2; P = 0.807), were independently associated with STS major morbidity and mortality.
conclusionsMICS valve surgical procedure for endocarditis appears both safe and effective, with repair rates and risk-adjusted outcomes similar to those of open surgical procedure.
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