Late outcomes of Heart-port compared with full sternotomy mitral valve repair

BACKGROUND:

There are different surgical techniques for repairing the mitral valve. The Heart-port (HP) technique has been introduced in order to achieve a few significant parameters among which are decreased post-operation pain, shorter recovery times and lower wound complications. It also has the advantage of being more aesthetic but, it is also known to be technically more demanding. We decided to compare our long term clinical and echocardiographic results of the traditional full sternotomy incision to the HP technique.

METHODS:

Between the years of 2004-2018, 1070 patients underwent repair of the mitral valve due to degenerative mitral disease. After propensity score matching we achieved two groups of 158 patients each who underwent either a full sternotomy procedure or a HP mitral valve repair.

Mean age was 51.3±12.3 in the full sternotomy group versus 50.8±11.7 in the HP group (p=0.743).

All patients were prospectively followed and long term clinical and echocardiographic outcomes were compared and analyzed.

RESULTS:

Hospital mortality was 1(1%) in the full sternotomy group versus 0(0%) in the HP group (p=1.000). At a mean follow-up of 105±50 months (range: 1-187), survival was 97.1% in the full sternotomy group versus 97.9% in the HP group (p=0.128), freedom from re-operation on the mitral valve was 92% and 92% in the sternotomy and HP groups respectively (p=1.000) and freedom from moderate or severe recurrent MR was 87% in the full sternotomy group versus 83% in the HP group (p=0.525).

CONCLUSIONS:

In selected patients, the HP technique for mitral valve repair has good long term clinical and echocardiographic results and therefore is recommended as a surgical choice whenever feasible.