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Purposes <p>Minimally invasive endoscopic mitral valve repair (MVr) has been widely applied. However, the safety of performing additional procedures concomitantly with MVr has not been adequately evaluated. This study aimed to evaluate the incremental risk of endoscopic MVr by adding concomitant procedures.</p> Methods <p>We retrospectively analyzed the data of 629 patients who underwent totally endoscopic mitral valve repair (MVr) at our hospital between September 2011 and March 2024. We used a linear regression analysis to calculate the additional time required for each concomitant procedure as a surrogate marker of operative risk.</p> Results <p>The analysis showed that the operation time and aortic cross-clamp time (ACC) for isolated mitral valve repair as Y intercepts were 193 and 98&#xa0;min, respectively. The addition of aortic valve replacement significantly increased ACC time by 50&#xa0;min (95% confidence interval [CI], 38–62&#xa0;min), tricuspid annuloplasty added 35&#xa0;min (95% CI, 28–41&#xa0;min), and the Maze procedure added 15&#xa0;min (95% CI, 8–22&#xa0;min). However, obesity and a low left ventricular ejection fraction did not significantly influence the procedure times.</p> Conclusions <p>We quantified the additional procedure time necessary for each concomitant procedure as surrogate markers of incremental operative risk. Our findings may be useful for calculating the anticipated procedure time when concomitant procedures are planned for minimally invasive MVr.</p>

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Risk analysis of additional procedures concomitantly with totally endoscopic mitral valve repair

  • 期刊论文

  • 发表日期：

    2026年4月7日

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  • Riku Kato,
  • Ayumi Shintani,
  • Mayuko Ueda,
  • Toshiaki Ito

摘要

Purposes

Minimally invasive endoscopic mitral valve repair (MVr) has been widely applied. However, the safety of performing additional procedures concomitantly with MVr has not been adequately evaluated. This study aimed to evaluate the incremental risk of endoscopic MVr by adding concomitant procedures.

Methods

We retrospectively analyzed the data of 629 patients who underwent totally endoscopic mitral valve repair (MVr) at our hospital between September 2011 and March 2024. We used a linear regression analysis to calculate the additional time required for each concomitant procedure as a surrogate marker of operative risk.

Results

The analysis showed that the operation time and aortic cross-clamp time (ACC) for isolated mitral valve repair as Y intercepts were 193 and 98 min, respectively. The addition of aortic valve replacement significantly increased ACC time by 50 min (95% confidence interval [CI], 38–62 min), tricuspid annuloplasty added 35 min (95% CI, 28–41 min), and the Maze procedure added 15 min (95% CI, 8–22 min). However, obesity and a low left ventricular ejection fraction did not significantly influence the procedure times.

Conclusions

We quantified the additional procedure time necessary for each concomitant procedure as surrogate markers of incremental operative risk. Our findings may be useful for calculating the anticipated procedure time when concomitant procedures are planned for minimally invasive MVr.