ArticleJTCVS open2026
Comparative outcomes of totally endoscopic versus direct vision mini-thoracotomy mitral valve repair: A propensity score-matched retrospective analysis.
Article in JTCVS open, 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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7 authors.
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Abstract
Background: Totally endoscopic mitral valve repair has emerged as an alternative minimally invasive approach to direct vision mini-thoracotomy (DVMT) repair, using 3-dimensional thoracoscopic guidance and a smaller working incision without rib spreading. Whether these technical differences translate into improved outcomes remains uncertain. Methods: A propensity score-matched, retrospective analysis was conducted on 114 patients undergoing elective mitral valve repair for degenerative mitral regurgitation (MR) via totally endoscopic or DVMT approaches at 2 UK tertiary centers between 2015 and 2024. Patients were matched 1:1 on key preoperative variables. The primary outcome was clinically significant recurrent MR on follow-up echocardiography. Secondary outcomes assessed operative parameters and recovery metrics. Multivariate regression identified predictors of relevant outcomes. Results: Totally endoscopic repair was associated with lower odds of developing clinically significant recurrent MR (odds ratio, 0.05; 95% confidence interval, 0-0.32; Conclusions: The totally endoscopic approach achieved more durable repairs, with comparable perioperative safety to DVMT. The observed improvement in early repair durability remains hypothesis-generating and warrants further evaluation in larger studies with standardized long-term follow-up.
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