Do minimally invasive approaches improve outcomes of heart valve surgery?

With the development of techniques and technologies in the past decade, minimally invasive valve surgery (MIVS) has become a well-established surgical option for heart valve disease. Unlike emerging transcatheter valves, MIVS still requires cardiopulmonary bypass and cardiotomy. The only difference between minimally invasive and conventional valve operations is whether a full sternotomy is avoided or not. The minimally invasive approach has been shown to have some beneficial effects such as reduced blood transfusion and faster postoperative recovery. However, these could be limited and outweighed by the potential adverse effects of small access. Careful selection of patient, approach and perfusion strategy based on thorough preoperative assessment and each surgical team experience is necessary to perform MIVS safely.