Mitral valve repair with minimally invasive approaches vs sternotomy: A meta‐analysis of early and late results in randomized and matched observational studies

摘要: BACKGROUND AND AIM OF THE STUDY Minimally invasive cardiac surgery (MICS) for mitral valve repair (MVRp) has been increasingly used. This study aimed to evaluate the early and late results of MICS MVRp vs conventional sternotomy. MATERIALS METHODS A systematic review randomized controlled trials or observational studies (with matched populations) comparing reporting any following outcomes: mortality, failure, complications, blood transfusion, readmission within 30 days after discharge, long-term reoperation regurgitation, operative times, mechanical ventilation time, intensive care unit (ICU) stay, hospital stay. The pooled treatment effects were calculated using a random-effects model. RESULTS Ten involving 6792 patients (MICS: 3396 patients; Conventional: 3296 patients) met eligibility criteria. In analysis, significantly reduced risk transfusion (odds ratio [OR], 0.654; 95% confidence interval [CI] 0.462-0.928; P = .017) discharge (OR, 0.615; 0.456-0.829; P = .001). was associated with longer cross-clamp time (mean difference 14 minutes; CI, 7.4-21 minutes; P < .001), CPB (24 minutes; 14-35 minutes; total (36; 15-56 minutes; but shorter ICU stay (-8.5; CI -15; -1.8; P = .013) (-1.3, -2.1; -0.45; P = .003). meta-analysis found no significant regarding in-hospital nor complications. CONCLUSIONS Despite reduces as well rates need transfusion.