Endo-Aortic Balloon Occlusion versus Transthoracic Clamping in Minimally Invasive Mitral Valve Surgery
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: The present study compared the clinical outcome between endo-aortic balloon occlusion (EABO) and transthoracic clamping (TTC) in patients undergoing minimally invasive mitral valve surgery (MIMVS). METHODS: All patients from the Mini-Mitral International Registry undergoing MIMVS were primarily considered for study inclusion. One-to-one nearest neighbour propensity score matching considering clinically relevant baseline covariates. The matched cohort was investigated regarding the clinical outcome between EABO and TTC according to the end-point definitions of the Mitral Valve Academic Research Consortium. RESULTS: From 2015 to 2021, a total of 6884 patients were primarily included in the study. Propensity score matching resulted in a population of 733 matched pairs. Patients treated with EABO showed significantly lower rates of conversion to sternotomy (13 [1.8%] vs 34 [4. 6%]; P = .001), longer cardiopulmonary bypass time (124 min [105-147] vs 120 min [90-148]; P = .001), and a longer intubation time (11.8 h [7.9-22.2] vs 10.8 h [6.4-20.0]; P < .001). No statistically significant differences were observed regarding postoperative mortality, stroke, bleeding requiring revision, vascular complications, intensive care unit stay, or hospital length of stay. CONCLUSIONS: In patients undergoing MIMVS, EABO and TTC are excellent options for aortic clamping. EABO showed benefits over TTC with lower rates of conversion to full sternotomy.
Authors: Markus Kofler, Paolo Berretta, Nikolaos Bonaros, Giovanni Domenico Cresce, Mauro Rinaldi, Antonios Pitsis, Tom C Nguyen, Torsten Doenst, Manuel Wilbring, Marc Gerdisch, Joseph Lamelas, Frank Van Praet, Tristan Yan, Davide Pacini, Antonio Fiore, Nguyen Hoang Dinh, Pierluigi Stefano, Jörg Kempfert, Marco Di Eusanio
Institutions: Humboldt-Universität zu Berlin, Deutsches Herzzentrum der Charité, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Marche Polytechnic University, Innsbruck Medical University, Universität Innsbruck, Ospedale San Bortolo, University of Turin, Interbalkan Medical Center, Baptist Hospital of Miami, Jena University Hospital, Herzzentrum Dresden Universitätsklinik, Franciscan Health Indianapolis, University of Miami, Onze Lieve Vrouwziekenhuis Hospital, Royal Prince Alfred Hospital, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, Université Paris Cité, Hôpitaux Universitaires Henri-Mondor, University of Medicine and Pharmacy at Ho Chi Minh City, Azienda Ospedaliero-Universitaria Careggi
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4413637343