For a study, in many centers, minimally invasive mitral valve surgery (MIMVS) became the standard treatment for mitral valve disease. The anterolateral micro thoracotomy access was advantageous in preoperative surgery because it helped to avoid the dangers of multiple osteotomies. Researchers wanted to assess the technique’s safety. Between 2008 and 2019, all patients who had reoperative MIMVS were evaluated retrospectively. The primary outcome was 30-day major complications and mortality; secondary outcomes included long-term survival, reoperation rate, and recurrent regurgitation of more than moderate severity. 

With an average of 68 ± 8 years, 146 patients had reoperative MIMVS. The 30-day major complication and mortality composite result was 29.5%. The 30-day death rate was 6.2%, with a 3.4% stroke rate. The overall cohort’s survival rate was 89.7 ± 2.5% at one year, 71.6 ± 4.3% at five years, and 50.9 ± 5.9% in 8-years. Lower left ventricular function (HR 2.8; 95 % CI 1.5–5.0), GFR 60 (HR 2.1; 95 % CI 1.2–3.7), and active endocarditis (HR 6.4; 95 % CI 2.7–15.4) were found to be factors associated with reduced long-term survival in a Cox regression analysis. At five years, the cumulative incidence of re-operation following mitral valve replacement was 11.3 ± 3.2%, 16.2 ± 7.5% for repair.

The cumulative incidence of more than mild recurrent regurgitation following mitral valve replacement was 25.49% at three years. In the current investigation, minimally invasive access in reoperative mitral valve surgery resulted in identical 30-day mortality and stroke rates as repeat sternotomy results published in the literature.