Comparison of early and mid-term follow-up results between total thoracoscopic mitral valve repair and median sternotomy mitral valve repair

This study aims to compare the early and mid-term follow-up results of total thoracoscopic mitral valve repair versus median sternotomy mitral valve repair. Data from patients with mitral regurgitation treated in our hospital from January 2020 to December 2024 were collected, including 165 cases of total thoracoscopic mitral valve repair and 160 cases of median sternotomy mitral valve repair. Demographic characteristics, technical indicators, complications, and follow-up results were compared between the two groups. The results showed that the total thoracoscopic mitral valve repair group had a shorter ICU stay (30.2 ± 6.1 h vs. 75.3 ± 15.6 h, P < 0.001), shorter postoperative mechanical ventilation time (12.5 ± 4.2 h vs. 28.1 ± 4.6 h, P < 0.001), shorter hospital stay (8.6 ± 4.5d vs. 13.8 ± 7.6d, P < 0.001), and less postoperative drainage (157.2 ± 47.1 ml vs. 382.5 ± 181.5 ml, P < 0.001). There was no perioperative mortality in either group. Cardiac ultrasound follow-up results at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years post-surgery showed no statistically significant difference in the recurrence rate of mitral regurgitation (Grade IV) between the two groups (1.21% vs. 1.25%, P = 0.536). Total thoracoscopic mitral valve repair is reliable, minimally invasive, with fewer complications, faster recovery, and satisfactory perioperative outcomes.