title: Repair rate and durability of video assisted minimally invasive mitral valve surgery.
abstract: BACKGROUND
  Minimally invasive mitral valve surgery (MIMVS) through a right lateral thoracotomy has emerged as another option in cardiac surgery. We present our single center experience with regards to repair rate and durability of the repair in patients undergoing MIMVS.
  
  
  METHODS
  Between January 2009 and December 2012 a total of 312 consecutive patients underwent MIMVS. Baseline characteristics, operative variables, postoperative outcomes, and follow-up information about survival, major adverse cardiac and cerebrovascular event (MACCE)-free survival, valve competence, and freedom from reoperation were collected.
  
  
  RESULTS
  Mean age was 61 ± 13.1 years, median Euroscore 4 (0-13). The predominant valve pathology was degenerative disease (96.2%) with regurgitation (95.2%) and atrial fibrillation (23.1%). Bypass time was 147 ± 46, cross-clamp time 94 ± 32 minutes. All degenerative valves planned for repair (n = 281) were successfully repaired except for two (0.7%) resulting in a 99.3% repair rate. Eight patients (2.8%) had to be converted to sternotomy. Median ventilation time was 6.6 hours (0 to 460), ICU stay one day (0 to 96), and hospital stay eight days (3 to 61). Most of the patients did not need red blood cell transfusion (78.2%). One patient died in hospital due to acute respiratory distress syndrome (0.3%) and five suffered a permanent stroke (1.6%). In 294 patients (94.5%) follow-up was completed for a median of 22 months (0 to 53) with 95.5 ± 1.2% overall survival, 96.8 ± 1.2%, MACCE-free survival, and 94.8 ± 0.1% freedom from reoperation.
  
  
  CONCLUSIONS
  MIMVS is a safe approach with low morbidity and mortality that allows a high and durable repair rate with low reoperation rates and favorable short-term event-free survival.
authors.affiliation: Department for Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Diana
authors.initials: D
authors.lastname: Reser
authors.forename: Mathias
authors.initials: M
authors.lastname: van Hemelrijck
authors.forename: Jovana
authors.initials: J
authors.lastname: Pavicevic
authors.forename: Anna
authors.initials: A
authors.lastname: Platzmann
authors.forename: Etem
authors.initials: E
authors.lastname: Caliskan
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Stephan
authors.initials: S
authors.lastname: Jacobs
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D012086:Reoperation / Q000706:statistics & numerical data; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000706:statistics & numerical data*; D016896:Treatment Outcome