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Minimally invasive mitral valve reconstruction: is it an “all-comers” procedure?
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  • Giuseppe Speziale,
  • Giuseppe Santarpino,
  • Marco Moscarelli,
  • Nicola Di Bari,
  • Flavio Fiore,
  • Ignazio Condello,
  • Francesco Bartolomucci,
  • Maria Bellino,
  • Giuseppe Nasso
Giuseppe Speziale
GVM Care & Research
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Giuseppe Santarpino
Klinikum Nürnberg
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Marco Moscarelli
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Nicola Di Bari
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Flavio Fiore
GVM Care & Research
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Ignazio Condello
GVM Care and Research
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Francesco Bartolomucci
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Maria Bellino
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Giuseppe Nasso
GVM Care & Research

Corresponding Author:gnasso@libero.it

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Abstract

Background and aim of the study - The debate on the usefulness of the minimally invasive approach in mitral valve surgery is still open. The aim of this study is to describe a single-center case series of all comers undergoing minimally invasive mitral valve reconstruction. Methods - From 2010 to 2019, all the data recorded in the medical records of 893 consecutive patients undergoing mitral valve reconstruction through a right mini-thoracotomy were retrospectively collected. All patients were contacted by telephone for remote evaluation and integration of echocardiographic information on surgical results. Results - Mean age was 62.2±14.5; 447 (50%) were female and mean log EuroSCORE was 2.5±2.8%. At a mean follow-up of 4.1 ± 2.2 years (median 3.9), a total of 24 deaths (2.68%) were recorded. Twenty-four patients required rehospitalization for cardiac causes, 13 (1.4%) patients had at least moderate mitral insufficiency on follow-up echocardiography and, of these, 7 patients underwent reoperation (0.8%). The cumulative hazard showed that 8.3% of patients experienced at least one event at 5 years. NYHA class improved significantly with 874 patients in NYHA class I, 13 in NYHA class II, 6 in NYHA class III, and 0 in NYHA class IV at last follow-up (p <0.001 from baseline as reference point). Conclusions – In a high-volume center, mitral valve surgery using a minimally invasive approach is a feasible treatment option for all-comers and is associated with excellent results that are maintained at clinical and echocardiographic follow-up.