Work

Does Minimally Invasive Valve Surgery Improve Quality of Life Compared to Sternotomy? A Systematic Review

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background/Objectives: Minimally invasive valve surgery (MIVS) is increasingly employed as an alternative to conventional median sternotomy (MS) in the treatment of valvular heart disease. However, its impact on postoperative quality of life (QoL) remains incompletely understood. This systematic review and meta-analysis aimed to compare QoL outcomes between MIVS and MS, focusing on physical, psychological, and social dimensions, both in the short- and long-term postoperative periods. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Wiley Online Library databases for studies published between January 2020 and September 2025. Eligible studies included adult patients undergoing MIVS or MS and assessed QoL using validated instruments (SF-36, EQ-5D, MLHFQ, KCCQ). Random-effects models were used for meta-analysis, and standardized mean differences (SMDs) were calculated to estimate pooled effects. Results: Fifty-six studies with a combined sample of over 10,000 patients were included. MIVS was associated with significantly better short-term QoL outcomes across physical (SMD = 0.88; 95% CI: 0.74–1.02) and psychological domains (SMD = 0.47; 95% CI: 0.35–0.59). Patients also experienced earlier social reintegration and improved body image perception. Although these benefits diminished beyond 12 months, MIVS maintained a modest but persistent advantage in long-term QoL (≥5 years). Structured psychological support and cardiac rehabilitation programmes further enhanced physical and emotional recovery. Conclusions: MIVS confers meaningful benefits in postoperative QoL, particularly during the early recovery phase. Sustained improvements depend on comprehensive postoperative care, including rehabilitation and psychosocial support. Further long-term, standardized research is required to strengthen evidence and guide patient-centred surgical decision-making.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14248660

Authors: Andra Denis Marinescu, Stefan Andrei Oprea, Victor Sebastian Costache

Institution: Titu Maiorescu University

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137