A Single-center comparative analysis of sternotomy and minimally-invasive approach to mitral valve surgery: evaluating outcomes and healthcare resource implications

This thesis presents a single-center comparative analysis of sternotomy (STER) and minimally invasive minithoracotomy (MTH) approaches in mitral valve surgery. The study included 1,184 patients who underwent mitral valve surgery between January 2004 and December 2022. The primary objective was to assess differences in mortality, morbidity, and long-term survival between the two approaches. Secondary objectives included evaluating the impact on operative time, blood loss, and length of hospital stay. The study found that MTH was associated with a lower incidence of in-hospital mortality and a shorter intensive care unit stay. However, there was no significant difference in the overall length of hospital stay between the two groups. Long-term follow-up revealed a lower mortality rate and a reduced need for reoperation in the MTH group. The thesis concludes that MTH offers several advantages over STER, including reduced mortality, morbidity, and reoperation rates. However, the study acknowledges limitations due to its single-center retrospective design and the relatively small number of MTH cases. Despite these limitations, the findings suggest that MTH is a safe and effective alternative to STER for selected patients undergoing mitral valve surgery.