There is a paucity of data comparing the minimally invasive mitral valve repair (MiMVr) to the conventional approach in patients with degenerative disease. Our objective was to compare the outcomes of MiMVr to the traditional mitral valve repair through median sternotomy in patients with degenerative mitral valve disease. We conducted a retrospective study on 215 patients classified into two groups. Group 1 (n = 80) included those who had mitral valve repair through a right anterolateral video-assisted mini-thoracotomy, and group 2 (n = 135) was approached through a conventional median sternotomy. We compared the preoperative, operative, and postoperative data between groups. Both groups had echocardiographic follow-ups after 6 and 12 months. There was no difference in gender distribution between both groups, and patients who had median sternotomy were significantly older (median 37 (Q1-Q3, 29-44) vs. 54 (48-60) years; P < 0.001). Cardiopulmonary bypass (134.5 (130-138.5) vs. 99 (97-104) min; P < 0.001) and ischemic times (99 (95-105.5) vs. 78 (75-81) min; P < 0.001) were significantly shorter in patients who had median sternotomy. Patients with MiMVr had significantly lower blood loss (370 (315-390) vs. 550 (490-600) ml; P < 0.001) and ICU stay (5 (4.5-6) vs. 7 (7-8) days; P < 0.001). There was no difference between both groups regarding re-exploration for bleeding, postoperative stroke, wound infection, renal failure, and mortality. As regards postoperative echocardiography follow-up at 6 and 12 months after the operation, there were no significant changes in the mean mitral valve gradient within each group; however, the mean gradient was lower in the MiMVr group (3 (3-3.5) vs. 4 (3-5) mmHg; P < 0.001). There was no significant difference between both groups regarding mitral regurgitation severity during 6 and 12 months follow-up. Minimally invasive mitral valve repair in patients with degenerative pathology could be an alternative to conventional mitral valve surgery with comparable short-term and long-term outcomes.

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针对退行性病因的微创二尖瓣修复术：一项比较研究

很少有数据将微创二尖瓣修复 (MiMVr) 与退行性疾病患者的传统方法进行比较。我们的目标是在退行性二尖瓣疾病患者中比较 MiMVr 与通过胸骨正中切开术进行传统二尖瓣修复的结果。我们对分为两组的 215 名患者进行了一项回顾性研究。第 1 组（n = 80）包括通过右前外侧视频辅助微型开胸术进行二尖瓣修复的患者，第 2 组（n = 135）通过常规正中胸骨切开术进行治疗。我们比较了组间的术前、术中和术后数据。两组均在 6 个月和 12 个月后进行超声心动图随访。两组性别分布无差异，中位胸骨切开术的患者年龄显着更大（中位 37 (Q1-Q3, 29-44) 与 54 (48-60) 岁；P < 0.001）。体外循环（134.5 (130-138.5) 与 99 (97-104) 分钟；P < 0.001）和缺血时间（99 (95-105.5) 与 78 (75-81) 分钟；P < 0.001）明显更短在有正中胸骨切开术的患者中。MiMVr 患者的失血量显着降低（370 (315-390) 比 550 (490-600) ml；P < 0.001）和 ICU 住院时间（5 (4.5-6) 比 7 (7-8) 天；P < 0.001)。两组在再次探查出血、术后卒中、伤口感染、肾功能衰竭和死亡率方面没有差异。术后 6 个月和 12 个月的术后超声心动图随访显示，各组平均二尖瓣梯度无显着变化；然而，MiMVr 组的平均梯度较低（3 (3-3.5) 对 4 (3-5) mmHg；P < 0.001）。在 6 个月和 12 个月的随访期间，两组之间二尖瓣关闭不全的严重程度没有显着差异。对退行性病变患者进行微创二尖瓣修复可能是传统二尖瓣手术的替代方案，具有可比的短期和长期结果。