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Purpose <p>Minimally invasive mitral valve repair (MIMVR) offers several advantages over sternotomy, including reduced surgical trauma and faster recovery. However, the quality of repair and long-term functional outcomes have been debated due to the limited access involved. This study evaluates the success of repair, various methods used, functional outcomes, survival rates, and re-intervention rates in patients undergoing MIMVR at Caritas Hospital, Kerala, from 2016 to 2023.</p> Methods <p>A retrospective cohort study of 114 patients who underwent MIMVR via right mini-thoracotomy was conducted. The techniques included triangular resection, posterior annuloplasty ring, neochords reconstruction, leaflet resection, foldoplasty, and Alfieri stitch. Transoesophageal echocardiography (TOE), intraoperative saline injection test, and on-pump antegrade cardioplegia were used to assess repair integrity. Patients were followed up at 1, 3, and 12&#xa0;months post-discharge, and annually thereafter. The primary endpoints were survival and recurrent mitral regurgitation (MR), with secondary endpoints being periprocedural complications and freedom from reoperation.</p> Results <p>The mean follow-up period was 5&#xa0;years, with an 87% freedom from moderate or severe MR. The perioperative characteristics included a mean age of 52.13 ± 13.11&#xa0;years, with 72.8% male. The average cardiopulmonary bypass (CPB) and aortic cross-clamp times were 178.78 ± 33.85 and 128.58 ± 27.61&#xa0;min, respectively. No conversions to sternotomy were required. Postoperative outcomes showed no significant SAM or severe MR, with a stroke incidence of 1.75%. At 1&#xa0;year, 86.8% of patients were asymptomatic, with 12.3% having moderate or greater MR.</p> Conclusion <p>MIMVR can achieve high-quality functional outcomes without compromising durability and is associated with low postoperative morbidity. The study supports MIMVR as a viable alternative to conventional approaches, providing favourable safety and results in treating MR. The technique has been particularly effective in patients with degenerative disease, including myxomatous and Barlow’s disease, making it a preferred method at our institution.</p> Graphical abstract <p></p>

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Outcomes of minimally invasive mitral valve repair for non-rheumatic mitral regurgitation: an 8-year retrospective analysis

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Rajesh M. Ramankutty,
  • Jecco Ani Babu,
  • Aiswarya Mohan

摘要

Purpose

Minimally invasive mitral valve repair (MIMVR) offers several advantages over sternotomy, including reduced surgical trauma and faster recovery. However, the quality of repair and long-term functional outcomes have been debated due to the limited access involved. This study evaluates the success of repair, various methods used, functional outcomes, survival rates, and re-intervention rates in patients undergoing MIMVR at Caritas Hospital, Kerala, from 2016 to 2023.

Methods

A retrospective cohort study of 114 patients who underwent MIMVR via right mini-thoracotomy was conducted. The techniques included triangular resection, posterior annuloplasty ring, neochords reconstruction, leaflet resection, foldoplasty, and Alfieri stitch. Transoesophageal echocardiography (TOE), intraoperative saline injection test, and on-pump antegrade cardioplegia were used to assess repair integrity. Patients were followed up at 1, 3, and 12 months post-discharge, and annually thereafter. The primary endpoints were survival and recurrent mitral regurgitation (MR), with secondary endpoints being periprocedural complications and freedom from reoperation.

Results

The mean follow-up period was 5 years, with an 87% freedom from moderate or severe MR. The perioperative characteristics included a mean age of 52.13 ± 13.11 years, with 72.8% male. The average cardiopulmonary bypass (CPB) and aortic cross-clamp times were 178.78 ± 33.85 and 128.58 ± 27.61 min, respectively. No conversions to sternotomy were required. Postoperative outcomes showed no significant SAM or severe MR, with a stroke incidence of 1.75%. At 1 year, 86.8% of patients were asymptomatic, with 12.3% having moderate or greater MR.

Conclusion

MIMVR can achieve high-quality functional outcomes without compromising durability and is associated with low postoperative morbidity. The study supports MIMVR as a viable alternative to conventional approaches, providing favourable safety and results in treating MR. The technique has been particularly effective in patients with degenerative disease, including myxomatous and Barlow’s disease, making it a preferred method at our institution.

Graphical abstract