Original Articles
12 June 2025
Vol. 19 No. 2 (2025)
https://doi.org/10.4081/itjm.2025.1963

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

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Mechanical mitral valve replacement, quality of life, minimally invasive, sternotomy
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Authors

The Binh Nguyen
Hanoi Medical University; Cardiovascular Center, E Hospital, Hanoi, Viet Nam.
Tran-Thuy Nguyen
drtranthuyvd@gmail.com
Cardiovascular Center, E Hospital, Hanoi; VNU University of Medicine and Pharmacy, Hanoi, Viet Nam.
Long Hoang Luong
Department of iPS Cell and Regenerative Medicine, Kansai Medical University, Osaka, Japan.
Duc Hoang Nguyen
Hanoi Medical University, Vietnam; Cardiovascular Laboratories, Methodist Hospital, Merrillville, Indiana, United States.
Cong Huu Nguyen
Cardiovascular Center, E Hospital, Hanoi, Viet Nam.
Ngoc Thanh Le
Cardiovascular Center, E Hospital, Hanoi; VNU University of Medicine and Pharmacy, Hanoi, Viet Nam.
Bao Giang Kim
Hanoi Medical University, Viet Nam.

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.

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Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation 2021;143:e35-71. DOI: https://doi.org/10.1161/CIR.0000000000000932
Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 2022;43:561-632. DOI: https://doi.org/10.1093/ejcts/ezac209
Leviner DB, Abraham D, Ronai T, Sharoni E. Mechanical valves: past, present, and future—a review. J Clin Med 2024;13:3768. DOI: https://doi.org/10.3390/jcm13133768
Carpentier A, Loulmet D, Carpentier A, et al. Open heart operation under videosurgery and minithoracotomy. First case (mitral valvuloplasty) operated with success. C R Acad Sci III 1996;319:219-23. [Article in French].
Moscarelli M, Fattouch K, Gaudino M, et al. Minimal access versus sternotomy for complex mitral valve repair: a meta-analysis. Ann Thorac Surg 2020;109:737-44. DOI: https://doi.org/10.1016/j.athoracsur.2019.07.034
Falk V, Cheng DCH, Martin J, et al. Minimally invasive versus open mitral valve surgery: a consensus statement of the international society of minimally invasive coronary surgery (ISMICS) 2010. Innovations 2011;6:66-76. DOI: https://doi.org/10.1097/imi.0b013e318216be5c
Nissen AP, Miller CC, Thourani VH, et al. Less invasive mitral surgery versus conventional sternotomy stratified by mitral pathology. Ann Thorac Surg 2021;111:819-27. DOI: https://doi.org/10.1016/j.athoracsur.2020.05.145
Alkhouli M, Alqahtani F, Kawsara A, et al. National trends in mechanical valve replacement in patients aged 50 to 70 years. J Am Coll Cardiol 2020;76:2687-8. DOI: https://doi.org/10.1016/j.jacc.2020.09.608
Tatum JM, Bowdish ME, Mack WJ, et al. Outcomes after mitral valve repair: a single-center 16-year experience. J Thorac Cardiovasc Surg 2017;154:822-30.e2. DOI: https://doi.org/10.1016/j.jtcvs.2017.01.047
Rankin JS, Grau-Sepulveda M, Shahian DM, et al. The impact of mitral disease etiology on operative mortality after mitral valve operations. Ann Thorac Surg 2018;106:1406-13. DOI: https://doi.org/10.1016/j.athoracsur.2018.04.053
Chen SW, Chen CY, Chien-Chia Wu V, et al. Mitral valve repair versus replacement in patients with rheumatic heart disease. J Thorac Cardiovasc Surg 2022;164:57-67.e11. DOI: https://doi.org/10.1016/j.jtcvs.2020.07.117
Cetinkaya A, Poggenpohl J, Bramlage K, et al. Long-term outcome after mitral valve replacement using biological versus mechanical valves. J Cardiothorac Surg 2019;14:120. DOI: https://doi.org/10.1186/s13019-019-0943-6
Nasso G, Bonifazi R, Romano V, et al. Three-year results of repaired Barlow mitral valves via right minithoracotomy versus median sternotomy in a randomized trial. Cardiology 2014;128:97-105. DOI: https://doi.org/10.1159/000357263
Moscarelli M, Lorusso R, Abdullahi Y, et al. The effect of minimally invasive surgery and sternotomy on physical activity and quality of life. Heart Lung Circ 2021;30:882-7. DOI: https://doi.org/10.1016/j.hlc.2020.09.936
Yamada T, Ochiai R, Takeda J, et al. Comparison of early postoperative quality of life in minimally invasive versus conventional valve surgery. J Anesth 2003;17:171-6. DOI: https://doi.org/10.1007/s00540-003-0176-6
Walther T, Falk V, Metz S, et al. Pain and quality of life after minimally invasive versus conventional cardiac surgery. Ann Thorac Surg 1999;67:1643-7. DOI: https://doi.org/10.1016/S0003-4975(99)00284-2
Suri RM, Antiel RM, Burkhart HM, et al. Quality of life after early mitral valve repair using conventional and robotic approaches. Ann Thorac Surg 2012;93:761-9. DOI: https://doi.org/10.1016/j.athoracsur.2011.11.062
Iribarne A, Easterwood R, Russo MJ, et al. A minimally invasive approach is more cost-effective than a traditional sternotomy approach for mitral valve surgery. J Thorac Cardiovasc Surg 2011;142:1507-14. DOI: https://doi.org/10.1016/j.jtcvs.2011.04.038
Grossi EA, Goldman S, Wolfe JA, et al. Minithoracotomy for mitral valve repair improves inpatient and postdischarge economic savings. J Thorac Cardiovasc Surg 2014;148:2818-22.e1-3. DOI: https://doi.org/10.1016/j.jtcvs.2014.08.029
Huang LC, Chen DZ, Chen LW, et al. Health-related quality of life following minimally invasive totally endoscopic mitral valve surgery. J Cardiothorac Surg 2020;15:194. DOI: https://doi.org/10.1186/s13019-020-01242-8

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Minimally invasive versus median sternotomy for mechanical mitral valve replacement: a single-center comparative study of treatment outcomes and quality of life. (2025). Italian Journal of Medicine, 19(2). https://doi.org/10.4081/itjm.2025.1963
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