We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Journal of Comparative Effectiveness Research
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine
Review

Minimally invasive mitral valve surgery: evolution, techniques and outcomes

    Francois Dagenais

    Laval Hospital, Department of Cardiac Surgery, 2725 chemin Sainte-Foy, Québec, Canada, G1V 4G5.

    Search for more papers by this author

    Email the corresponding author at francois.dagenais@chg.ulaval.ca

    Published Online:18 Nov 2008https://doi.org/10.2217/14796678.4.6.609

    Abstract

    Surgical treatment of the mitral valve has evolved considerably since the 1920s. During the mid-1990s new approaches through small incisions have been proposed to access the mitral valve. We herein describe the evolution of mitral surgery, the development of minimally invasive mitral techniques and compare outcomes to a standard sternotomy approach.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

    Bibliography

    • 1  Cutler EC, Levine SA: Cardiotomy and valvulotomy for mitral stenosis: Experimental observations and clinical notes concerning an operated case with recovery. Boston Med. Surg.188,1023 (1923).Crossref, Google Scholar
    • 2  Souttar H: The surgical treatment of mitral stenosis. Br. Med. J.2,603–606 (1925).Crossref, Medline, CAS, Google Scholar
    • 3  Harken DE, Ellis LB, Ware PF, Norman LR: The surgical treatment of mitral stenosis: Valvuloplasty. N. Engl. J. Med.239,801 (1948).Crossref, Medline, CAS, Google Scholar
    • 4  Starr A, Edwards ML: Mitral replacement: Clinical experience with a ball valve prosthesis. Ann. Surg.154,726 (1961).Crossref, Medline, CAS, Google Scholar
    • 5  McGoon DC: Repair of mitral valve insufficiency due to ruptured chordae tendinae. J. Thorac. Cardiovasc. Surg.39,357–363 (1960).Crossref, Google Scholar
    • 6  Carpentier A, Deloche A, Dauptain J et al.: A new reconstructive operation for correction of mitral and tricuspid insufficiency. J. Thorac. Cardiovasc. Surg.61,1 (1971).▪ Classic paper on the initial description of valve repair techniques.Crossref, Medline, CAS, Google Scholar
    • 7  Duran CG, Pomar JL, Revuelta JM et al.: Conservative operation for mitral insufficiency. Critical analysis supported by postoperativehemodynamic studies in 72 patients. J. Thorac. Cardiovasc. Surg.79,326 (1980).Crossref, Medline, CAS, Google Scholar
    • 8  Carpentier A, Chauvaud S, Fabiani J et al.: Reconstructive surgery of mitral valve incompetence: ten year appraisal. J. Thorac. Cardiovasc. Surg.79,338 (1980).▪ Describes initial midterm results of mitral repair.Crossref, Medline, CAS, Google Scholar
    • 9  Xu M, McHaffie DJ, Hillness AD: Mitral valve repair: a clinical and echocardiographic study. Br. Heart J.71,51 (1994).Crossref, Medline, CAS, Google Scholar
    • 10  Cosgrove DM III, Sabik JF, Navia JL: Minimally invasive valve operations. Ann. Thorac. Surg.67,1535–1538 (1998).Crossref, Google Scholar
    • 11  Karagoz HY, Bayazit K, Battaloglu B et al.: Minimally invasive mitral valve surgery: the subxiphoid approach. Ann. Thorac. Surg.67,1328–1332 (1999).Crossref, Medline, CAS, Google Scholar
    • 12  Arom KV, Emery RW: Minimally invasive mitral operations. Ann. Thorac. Surg.63,1219–1220 (1997).Crossref, Medline, CAS, Google Scholar
    • 13  Pompili MF, Stevens JH, Burdon TA et al.: Port-Access mitral valve replacement in dogs. J. Thorac. Cardiovasc. Surg.112,1268–1274 (1996).Crossref, Medline, CAS, Google Scholar
    • 14  Colvin SB, Galloway AC, Ribakove G et al.: Port-Access mitral surgery: summary of results. J. Card. Surg.13,286–289 (1998).▪▪ Overview of initial results of the Port-Access technology.Crossref, Medline, CAS, Google Scholar
    • 15  Chitwood WR, Elbeery JR, Moran JM: Minimally invasive mitral valve repair using a minithoracotomy and transthoracic aortic occlusion. Ann. Thorac. Surg.63,1477–1479 (1997).Crossref, Medline, Google Scholar
    • 16  Casselman FP, Van Slycke S, Wellens F et al.: Mitral valve surgery can now routinely be performed endoscopically. Circulation108,1148–1154 (2003).Crossref, Google Scholar
    • 17  Jeanmart H, Casselman FP, De Grieck Y et al.: Avoiding vascular complications during minimally invasive, totally endoscopic surgery. J. Thorac. Cardiovasc. Surg.133,1066–1070 (2007).▪ Paper assessing vascular complications related mainly to the use of the aortic endoclamp.Crossref, Medline, Google Scholar
    • 18  Antonic M, Gersak B: Renal function after Port-Access and median sternotomy mitral surgery. Heart Surg. Forum10,E401–E407 (2007).Crossref, Medline, Google Scholar
    • 19  McCreath BJ, Swaminathan M, Booth JV et al.: Mitral valve surgeryand acute renal injury: Port Access versus median sternotomy. Ann. Thorac. Surg.75,812–819 (2003).Crossref, Medline, Google Scholar
    • 20  Casselman FP, Van Slycke S, Dom H, Lambrechts DL, Vermeulen Y, Vanermen H: Endoscopic mitral valve repair: feasible, reproducible, and durable. J. Thorac. Cardiovasc. Surg.125,273–282 (2003).▪▪ Manuscript describing techniques and results of endoscopic mitral surgery.Crossref, Medline, Google Scholar
    • 21  Aybek T, Dogan S, Risteski PS et al.: Two hundred forty minimally invasive mitral operations through right minithoracotomy. Ann. Thorac. Surg.81,1618–1624 (2006).▪ Single institution experience with the right mini-thoracotomy.Crossref, Medline, Google Scholar
    • 22  Onnasch JF, Schneider F, Falk V et al.: Five years of less invasive mitral valve surgery: from experimental to routine approach. Heart Surg. Forum5,132–135 (2002).Medline, Google Scholar
    • 23  Caffarelli AD, Robbins RC: Will minimally invasive valve replacement ever really be important? Curr. Opin. Cardiol.19,123–127 (2004).Crossref, Medline, Google Scholar
    • 24  Dogan S, Aybek T, Risteski PS et al.: Minimally invasive Port Access versus conventional mitral surgery: prospective randomized study. Ann. Thorac. Surg.79,492–498 (2005).▪ Sole randomized study comparing the right mini-thoracotomy and the standard sternotomy.Crossref, Medline, Google Scholar
    • 25  Schroeyers P, Wellens F, DeGeest R et al.: Minimally invasive video-assisted mitral valve repair: short and mid-term results. J. Heart Valve Dis.10,579–583 (2001).Medline, CAS, Google Scholar
    • 26  Cohn LH: Minimally invasive valve surgery. J. Card. Surg.16,260–265 (2001).▪▪ Excellent review of techniques and outcome of minimally invasive valve surgery.Crossref, Medline, CAS, Google Scholar
    • 27  Grossi EA, Galloway AC, LaPietra A et al.: Minimally invasive mitral valve surgery: a 6-year experience in 714 patients. Ann. Thorac. Surg.74,660–663 (2002).Crossref, Medline, Google Scholar
    • 28  Walther T, Falk V, Metz S et al.: Pain and quality of life after minimally invasive versus conventional cardiac surgery. Ann. Thorac. Surg.67,1643–1637 (1999).Crossref, Medline, CAS, Google Scholar
    • 29  Mishaly D, Ghosh P, Preisman S et al.: Minimally invasive congenital cardiac surgery through right anterior minithoracotomy approach. Ann. Thorac. Surg.85,831–835 (2008).Crossref, Medline, Google Scholar
    • 30  El Oumeiri B, Casselman F, Vanermen H: Video-assisted left ventricle mass removal. Eur. J. Cardiothorac. Surg.32,383 (2007).Crossref, Medline, Google Scholar
    • 31  Dupont M, Mullens W, DeBruyne B, Vanermen H: Myotomy through heart-port access for myocardial bridging. Int. J. Cardiol.124,E16–E18 (2008).Crossref, Medline, Google Scholar
    • 32  Sharony R, Grossi EA, Saunders PC et al.: Minimally invasive reoperative isolated valve surgery: early and mid-term results. J. Card. Surg.21,240–244 (2006).Crossref, Medline, Google Scholar
    • 33  Casselman FP, La Meir M, Jeanmart H et al.: Endoscopic mitral and tricuspid valve surgery after previous cardiac surgery. Circulation116,I270–I275 (2007).▪ Manuscript reporting use of the right mini-thoracotomy in reoperations.Crossref, Google Scholar
    • 34  Felger JE, Niffong LW, Chitwood WR Jr: The evolution of and early experience with robotic-assisted mitral valve surgery. Surg. Laparosc. Endosc. Percutan. Tech.12,58–63 (2002).Crossref, Medline, Google Scholar
    • 35  Folliguet T, Vanhuyse F, Constantino X et al.: Mitral valve repair robotic versus sternotomy. Eur. J. Cardiothorac. Surg.29,362–366 (2006).Crossref, Medline, Google Scholar
    • 36  Feldman T, Wasserman HS, Hermann HC et al.: Percutaneous mitral valve repair using the edge-to-edge technique: six-month results of the EVEREST Phase I Clinical Trial. J. Am. Coll. Cardiol.46(11),2134–2140 (2005).Crossref, Medline, Google Scholar
    • 37  Block PC: Percutaneous transcatheter repair for mitral regurgitation. J. Interv. Cardiol.19(6),547–551 (2006).Crossref, Medline, Google Scholar