Minimally invasive versus median sternotomy for mechanical mitral valve replacement: a single-center comparative study of treatment outcomes and quality of life

Mechanical mitral valve replacement (MMVR) is normally indicated for severe, irreparable mitral valve disease and is often performed through median sternotomy (MS). Compared with the traditional MS approach, the minimally invasive (MI) technique offers benefits like reduced trauma, faster recovery, and improved cosmetic outcomes. Because most studies focused on the MI approach in mitral valve repair, data on the outcome of MI MMVR are very limited. Thus, we conducted this study to compare treatment outcomes and quality of life in patients undergoing MMVR using MI vs. MS techniques. A total of 86 patients (43 MI, 43 MS) were recruited from 2019 to 2024, with follow-up at 36 months post-surgery. Cosmesis was assessed using the Scar Cosmesis Assessment and Rating Scale; quality of life was evaluated via the Short Form-36 questionnaire. The MI group had longer cardiopulmonary bypass and cross-clamp times but shorter ventilation times, intensive care unit stays, hospital stays, lower costs, and better cosmetic outcomes compared to the MS group (p<0.05). In conclusion, MI for MMVR is a safe technique that reduces short-term recovery times and costs, resulting in improved cosmetic and postoperative quality of life.