Midterm Echocardiographic Outcomes of Minimally Invasive Mitral Valve Surgery in Patients With Previous Cardiac Surgery
Bibliographic record
Abstract
Background: Minimally invasive mitral valve repair (MVr) and mitral valve replacement (MVR) after previous sternotomy are relatively uncommon. This study reports midterm outcomes at a single institution. Methods: All patients with a history of previous cardiac surgery who underwent minimally invasive MVr and MVR with hypothermic fibrillatory arrest at our institution (Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada) between 2006 and 2024 were included. Follow-up echocardiographic reports were reviewed at 1 year, 1 to 3 years, 3 to 5 years, and 5+ years. Primary outcomes included postoperative complications, all-cause mortality, and rates of grade 3 to 4 mitral regurgitation at follow-up. Results: A total of 31 patients met the inclusion criteria (25.8% female patients), and their median age was 64 years. A total of 18 patients underwent MVR, and 13 underwent MVr. The most common previous cardiac operations were aortic valve replacement (AVR), coronary artery bypass graft, and MVR. All redo procedures were completed using hypothermic fibrillatory arrest (mean, 23.3 [2.5] °C; median duration, 143.0 minutes [interquartile range, 110.5-175.0 minutes]) for myocardial protection. The 30-day, 5-year, and 10-year all-cause mean mortality rates were 0.0% (0.0%), 12.9% (6.0%), and 25.8% (7.9%), respectively. Patients with previous AVR with or without ascending aortic replacement represented 50% of total deaths. Overall, 4 (12.9%) patients had recurrent grade 3 to 4 mitral regurgitation: 3 died, and 1 had subsequent double-redo MVR. Conclusions: Our study demonstrates low perioperative mortality rates, thus implying the safety of fibrillatory arrest for myocardial protection in redo minimally invasive MVr and MVR. We also identified that patients with AVR with or without ascending aortic replacement face a higher midterm risk, given the technical difficulty of operating with fibrillatory arrest on the anterolateral portion of the mitral valve when the aortic annulus or root is inflexible.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.007 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".