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Misfeld M, Borger M, Byrne JG, et al. Cross-sectional survey on minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2013;2(6):733-8doi: 10.3978/j.issn.2225-319X.2013.11.11.
Misfeld, M., Borger, M., Byrne, J. G., Chitwood, W. R., Cohn, L., Galloway, A., Garbade, J., Glauber, M., Greco, E., Hargrove, C. W., Holzhey, D. M., Krakor, R., Loulmet, D., Mishra, Y., Modi, P., Murphy, D., Nifong, L. W., Okamoto, K., Seeburger, J., Tian, D. H., Vollroth, M., & Yan, T. D. (2013). Cross-sectional survey on minimally invasive mitral valve surgery. Annals of cardiothoracic surgery, 2(6), 733-8. https://doi.org/10.3978/j.issn.2225-319X.2013.11.11
Misfeld, Martin, et al. "Cross-sectional survey on minimally invasive mitral valve surgery." Annals of cardiothoracic surgery vol. 2,6 (2013): 733-8. doi: https://doi.org/10.3978/j.issn.2225-319X.2013.11.11
Misfeld M, Borger M, Byrne JG, Chitwood WR, Cohn L, Galloway A, Garbade J, Glauber M, Greco E, Hargrove CW, Holzhey DM, Krakor R, Loulmet D, Mishra Y, Modi P, Murphy D, Nifong LW, Okamoto K, Seeburger J, Tian DH, Vollroth M, Yan TD. Cross-sectional survey on minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2013 Nov;2(6):733-8. doi: 10.3978/j.issn.2225-319X.2013.11.11. PMID: 24349974; PMCID: PMC3856993.
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Ann Cardiothorac Surg. 2013 Nov;2(6):733-8. doi: 10.3978/j.issn.2225-319X.2013.11.11.

Cross-sectional survey on minimally invasive mitral valve surgery.

Annals of cardiothoracic surgery

Martin Misfeld, Michael Borger, John G Byrne, W Randolph Chitwood, Lawrence Cohn, Aubrey Galloway, Jens Garbade, Mattia Glauber, Ernesto Greco, Clark W Hargrove, David M Holzhey, Ralf Krakor, Didier Loulmet, Yugal Mishra, Paul Modi, Douglas Murphy, L Wiley Nifong, Kazuma Okamoto, Joerg Seeburger, David H Tian, Marcel Vollroth, Tristan D Yan

Affiliations

  1. Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany;
  2. Departmemnt of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN, USA;
  3. Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, USA;
  4. Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA;
  5. Department of Cardiothoracic Surgery, New York University Medical Center, New York, NY, USA;
  6. Cardiac Surgery Department, G. Pasquinucci Heart Hospital, Massa, Italy;
  7. Departments of Cardiovascular Surgery and Anaesthesia, Policlinica Gipuzkoa, San Sebastian, Spain;
  8. Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA;
  9. Heart Center Dortmund, Klinikum Dortmund gGmbH, Dortmund, Germany;
  10. Department of Cardiac Surgery, Escorts Heart Institute and Research Centre Ltd, Okhla Road, New Delhi, India;
  11. Liverpool Heart and Chest Hospital, Liverpool, UK;
  12. Saint Joseph's Hospital of Atlanta, Atlanta, GA, USA;
  13. Department of Cardiovascular Surgery, Keio University, Tokyo, Japan;
  14. The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia.

PMID: 24349974 PMCID: PMC3856993 DOI: 10.3978/j.issn.2225-319X.2013.11.11

Abstract

BACKGROUND: Minimally invasive mitral valve surgery (MIMVS) has become a standard technique to perform mitral valve surgery in many cardiac centers. However, there remains a question regarding when MIMVS should not be performed due to an increased surgical risk. Consequently, expert surgeons were surveyed regarding their opinions on patient factors, mitral valve pathology and surgical skills in MIMVS.

METHODS: Surgeons experienced in MIMVS were identified through an electronic search of the literature. A link to an online survey platform was sent to all surgeons, as well as two follow-up reminders. Survey responses were then submitted to a central database and analyzed.

RESULTS: The survey was completed by 20 surgeons. Overall results were not uniform with regard to contraindications to performing MIMVS. Some respondents do not consider left atrial enlargement (95% of surgeons), complexity of surgery (75%), age (70%), aortic calcification (70%), EuroSCORE (60%), left ventricular ejection fraction (55%), or obesity (50%) to be contraindication to surgery. Ninety percent of respondents believe more than 20 cases are required to gain familiarity with the procedure, while 85% believe at least one MIMVS case needs to be performed per week to maintain proficiency. Eighty percent recommend establishment of multi-institutional databases and standardized surgical mentoring courses, while 75% believe MIMVS should be incorporated into current training programs for trainees.

CONCLUSIONS: These results suggest that MIMVS has been accepted as a treatment option for patients with mitral valve pathologies according the expert panel. Initial training and continuing practice is recommended to maintain proficiency, as well as further research and formalization of training programs.

Keywords: Minimally invasive mitral valve surgery; contraindications; cross sectional survey; surgical expertise; training programs

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