Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis

<b>Background:</b> This study evaluates the outcomes of isolated mitral valve surgery for infective endocarditis performed via conventional full sternotomy or minimally invasive right minithoracotomy. While minimally invasive surgery (MIS) is well-established for elective mitral procedur...

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Main Authors: Elisa Mikus, Mariafrancesca Fiorentino, Diego Sangiorgi, Antonino Costantino, Simone Calvi, Elena Tenti, Elena Tremoli, Alberto Tripodi, Carlo Savini
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Diseases
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Online Access:https://www.mdpi.com/2079-9721/13/5/135
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author Elisa Mikus
Mariafrancesca Fiorentino
Diego Sangiorgi
Antonino Costantino
Simone Calvi
Elena Tenti
Elena Tremoli
Alberto Tripodi
Carlo Savini
author_facet Elisa Mikus
Mariafrancesca Fiorentino
Diego Sangiorgi
Antonino Costantino
Simone Calvi
Elena Tenti
Elena Tremoli
Alberto Tripodi
Carlo Savini
author_sort Elisa Mikus
collection DOAJ
description <b>Background:</b> This study evaluates the outcomes of isolated mitral valve surgery for infective endocarditis performed via conventional full sternotomy or minimally invasive right minithoracotomy. While minimally invasive surgery (MIS) is well-established for elective mitral procedures, its role in infective endocarditis remains less explored due to the complexity of the disease. <b>Methods:</b> A retrospective analysis of 134 patients who underwent isolated mitral valve surgery for infective endocarditis between January 2010 and March 2024 was conducted. Patients were divided into two groups based on the surgical approach: full sternotomy (n = 94) and MIS via right minithoracotomy (n = 40). Variables analyzed included preoperative characteristics, intraoperative details, and postoperative outcomes, such as mortality, complications, and hospital stay duration. Given significant baseline differences, inverse probability weighting was applied for comparability. <b>Results:</b> Mitral valve replacement was performed in 77% of cases. After adjustment, the MIS group demonstrated shorter intensive care unit stays (<i>p</i> = 0.018), with no significant differences in in-hospital mortality (<i>p</i> = 0.145) or total hospitalization length (<i>p</i> = 0.151). <b>Conclusions:</b> Minimally invasive mitral valve surgery is a safe and effective alternative to sternotomy in infective endocarditis, offering comparable outcomes with shorter ICU stays. Further research is needed to refine patient selection and validate these findings.
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spelling doaj-art-cc3ed90ac8c940b196606cd890afc72e2025-08-20T03:47:48ZengMDPI AGDiseases2079-97212025-04-0113513510.3390/diseases13050135Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative AnalysisElisa Mikus0Mariafrancesca Fiorentino1Diego Sangiorgi2Antonino Costantino3Simone Calvi4Elena Tenti5Elena Tremoli6Alberto Tripodi7Carlo Savini8Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, ItalyCardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, RA, Italy<b>Background:</b> This study evaluates the outcomes of isolated mitral valve surgery for infective endocarditis performed via conventional full sternotomy or minimally invasive right minithoracotomy. While minimally invasive surgery (MIS) is well-established for elective mitral procedures, its role in infective endocarditis remains less explored due to the complexity of the disease. <b>Methods:</b> A retrospective analysis of 134 patients who underwent isolated mitral valve surgery for infective endocarditis between January 2010 and March 2024 was conducted. Patients were divided into two groups based on the surgical approach: full sternotomy (n = 94) and MIS via right minithoracotomy (n = 40). Variables analyzed included preoperative characteristics, intraoperative details, and postoperative outcomes, such as mortality, complications, and hospital stay duration. Given significant baseline differences, inverse probability weighting was applied for comparability. <b>Results:</b> Mitral valve replacement was performed in 77% of cases. After adjustment, the MIS group demonstrated shorter intensive care unit stays (<i>p</i> = 0.018), with no significant differences in in-hospital mortality (<i>p</i> = 0.145) or total hospitalization length (<i>p</i> = 0.151). <b>Conclusions:</b> Minimally invasive mitral valve surgery is a safe and effective alternative to sternotomy in infective endocarditis, offering comparable outcomes with shorter ICU stays. Further research is needed to refine patient selection and validate these findings.https://www.mdpi.com/2079-9721/13/5/135endocarditisminimally invasivemitral valve surgeryaortic valve replacement
spellingShingle Elisa Mikus
Mariafrancesca Fiorentino
Diego Sangiorgi
Antonino Costantino
Simone Calvi
Elena Tenti
Elena Tremoli
Alberto Tripodi
Carlo Savini
Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis
Diseases
endocarditis
minimally invasive
mitral valve surgery
aortic valve replacement
title Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis
title_full Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis
title_fullStr Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis
title_full_unstemmed Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis
title_short Minimally Invasive Versus Full Sternotomy Approaches in Mitral Valve Surgery for Infective Endocarditis: A Retrospective Comparative Analysis
title_sort minimally invasive versus full sternotomy approaches in mitral valve surgery for infective endocarditis a retrospective comparative analysis
topic endocarditis
minimally invasive
mitral valve surgery
aortic valve replacement
url https://www.mdpi.com/2079-9721/13/5/135
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AT diegosangiorgi minimallyinvasiveversusfullsternotomyapproachesinmitralvalvesurgeryforinfectiveendocarditisaretrospectivecomparativeanalysis
AT antoninocostantino minimallyinvasiveversusfullsternotomyapproachesinmitralvalvesurgeryforinfectiveendocarditisaretrospectivecomparativeanalysis
AT simonecalvi minimallyinvasiveversusfullsternotomyapproachesinmitralvalvesurgeryforinfectiveendocarditisaretrospectivecomparativeanalysis
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