After simplification of the surgical procedure, the mortality decreased to 3%. Vanermen et al. demonstrated that ICU and hospital stays decrease with increasing experience . There are potential vascular risks with femoral cannulation, especially with selleck chem ARQ197 the larger port access femoral cannula. Groin seromas can be problematic but are kept to a minimum by dissection of only of the anterior surface of the vessels as well as clipping lymphatics. When the pericardium is opened too posteriorly, phrenic nerve palsy has been reported and can be avoided by placing the pericardiotomy at least 3cm anterior to it. Excess tension by pericardial retraction sutures should be avoided. 14. Conclusion Cardiac valve surgery operations have historically been performed via a standard median sternotomy and CPB.
With the advent of minimally invasive surgery, several new observations regarding the treatment of patients with isolated valve disease have arisen. Over the last decade there has been transformation in the way cardiac surgeons, cardiologists, and patients decide the approach to cardiac therapies. Patients now demand less-invasive procedures with equivalent safety, efficacy, and durability. Any form of new technology must provide better outcome and have better efficiency in terms of safety and durability. If scientific evidence shows that mini-VS results in lower complication rates, surgeons must be trained in these newer techniques. However, with different training backgrounds, patient populations, and surgical approaches, surgeons should use the technique that they believe will result in the best outcome and with which they feel most comfortable.
The recent STS data shows that 11.3% of isolated mitral valve repairs are performed with robotic assistance . Up to 20% surgeons are using some minimally invasive methods for their repairs . Critically appraising the results of MIMVS has several limitations, based on the paucity of randomised controlled trials and the reliance on single centre case series or few other review papers. Furthermore, the definition of ��minimally invasive�� is controversial. The STS  defines minimally invasive surgery as any procedure not performed with a full sternotomy and CPB; however, this definition does not really fit into valve surgery.
We have attempted to review the various aspects of MIMVS, and the studies reviewed do not show a significant difference in operative mortality between minimally invasive and conventional approaches. Moreover, the long-term outcomes of these procedures appear to be as durable as the conventional approaches (with followup of up to 8 years). There has been almost no doubt that these Batimastat procedures reduce the length of hospital stay and blood transfusion while at the same time being cosmetically more attractive than the conventional approach.