ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Comparison of Cannulation Strategies for Minimally Invasive Mitral Valve Surgery.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMinimally invasive mitral valve surgery (MIV-MVS) continues to evolve through refinements in surgical technique and perioperative management. This study evaluated the association between arterial cannulation strategy and perioperative adverse events.
methodsThree arterial cannulations were used: central ascending aortic cannulation (AC), open femoral cannulation via groin cutdown (oFC), and percutaneous femoral cannulation (pFC) using pre-closure devices. Patients from 2 centres were assessed for the composite safety end-point of 30-day mortality or stroke, the composite efficacy end-point of all-cause death, stroke, or cannulation-related adverse events, and postoperative delirium. Cannulation-related adverse events included conversion to sternotomy or re-thoracotomy, vessel dissection or bleeding, and cannulation-site infection.
resultsBetween January 2013 and January 2020, 823 patients underwent MIV-MVS. Aortic cannulation was performed in 266 patients (32.3%), oFC in 396 (48.1%), and pFC in 161 (19.6%). The composite end-point of 30-day all-cause death or stroke occurred in 19 patients (2.3%) and was similar between AC and FC (odds ratio [OR] 1.16, 95% CI, 0.41-3.16). The extended composite efficacy end-point occurred less frequently with AC than with any FC (OR 0.46, 95% CI, 0.21-0.94), mainly due to fewer access-site complications. Aortic cannulation was also associated with lower odds of perioperative delirium (OR 0.51, 95% CI, 0.29-0.86). No significant difference was observed between oFC and pFC.
conclusionsIn patients undergoing MIV-MVS, 30-day death or stroke was similar across cannulation strategies. Aortic cannulation was associated with a lower rate of cannulation-related complications and less perioperative delirium than FC, largely reflecting fewer access-site complications. Further prospective external validation is warranted.
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