Mid-term outcomes after totally video guided thoracoscopic mitral valve surgery

Totally video-guided thoracoscopic surgery (TVTS) has emerged as a minimally invasive alternative to conventional surgery with full sternotomy for mitral valve surgery. Evaluation of clinical outcomes of TVTS mitral valve surgery is essential for guiding patient selection and surgical planning. We conducted a retrospective study of 368 consecutive patients who underwent TVTS for mitral valve repair at a tertiary academic center to evaluate the safety and efficacy of this minimally invasive approach. Mitral valve repair was accomplished using the respect technique in 96.4% %, using two PTFE artificial-cordae on the posterior leaflet in 61.7% of patients. In-hospital mortality was 0.8%, stroke 1.2% and ECMO support was required for 1.4% of patients. The median follow-up was 2.5 years (q1; q3 1.18;4.15) and it was complete in 98.6% of patients. At 5-year, all-cause mortality was 3.0% and the rate of major cardiac and cerebrovascular events and reoperations were respectively 1.9% and 1.7%. Provided adequate surgical expertise, TVTS mitral valve surgery can be performed with good early and mid-clinical outcomes.