The impact of comorbidities on surgical outcome and mortality in minimally invasive mitral valve surgery: a systematic review.

Background: We sought to outline perioperative patient data to analyse surgical, clinical and echocardiographic outcomes and mortality of patients undergoing minimally invasive mitral valve surgery. Methods: Systematic literature research was performed in MEDLINE/PubMed according to PRISMA guidelines. Our research considered original works published until January 31, 2025. A pooled meta-analysis of studies reports early and late follow-up data of mitral valve repair for complex mitral valve regurgitation. In order to outline possible adverse events and comorbidities, we compared patients' mortality by differentiating preoperative, intraoperative and postoperative data. Results: This review analysed publications involving 222,947 patients, of which 43.4% were female and 56.6% were male, who underwent minimally invasive mitral valve surgery (MIMVS). The patients had a median age of 63.40 years (IQR: 60.42, 68.00), an average BMI of 25.1 kg/m Conclusions: Postoperative mortality was associated with comorbidities like chronic kidney disease, diabetes mellitus and hypercholesterolaemia. Patients with a history of smoking, arterial hypertension or coronary artery disease showed variable risks, indicating that these factors may be associated with elevated in-hospital death or death within the first postoperative month. MIMVS shows favourable outcomes concerning echocardiographic measurements and haemodynamics such as LVEF, as well as length of hospital stay, ICU stay, postprocedural bleeding and complications such as wound infection or the need for blood transfusions.