A new study by Moroccan anesthesiologists and cardiovascular specialists has found that minimally invasive cardiac surgery (MICS) offers a safer and more effective alternative to conventional median sternotomy (CMS) for patients suffering from severe rheumatic mitral valve disease.
Published in the open-access medical journal Cureus, the multicenter retrospective study analyzed outcomes for 55 adult patients who underwent elective mechanical mitral valve replacement between 2020 and 2024.
Patients were split into two groups: 27 underwent minimally invasive procedures, while 28 underwent traditional open-chest surgery. The primary goal was to assess all-cause mortality within 30 days post-operation.
The study found that MICS was associated with significantly shorter cardiopulmonary bypass time (68.3 vs. 87.5 minutes), reduced aortic cross-clamp time (54.7 vs. 77.1 minutes), lower incidence of postoperative pneumonia (0% vs. 10.7%), and fewer arrhythmias (7.4% vs. 39.3%).
Patients in the MICS group also had shorter hospital stays (6.2 vs. 7.3 days), with similar outcomes in ICU duration and long-term ventricular function at 12 months.
The study was conducted by teams at several Moroccan military hospitals in Marrakech, Rabat, and Agadir, including lead researchers Hicham Kabiri, Rachid Sadiki, and Youssef Qamous.
Researchers emphasized that while both surgical approaches maintained comparable long-term outcomes, MICS led to fewer early complications and faster recovery.
Rheumatic heart disease, a long-term consequence of untreated streptococcal infections, remains a leading cause of cardiovascular morbidity and mortality in low- and middle-income countries, with over 39 million people affected globally, primarily in sub-Saharan Africa, South Asia, and parts of the Middle East.
Limited access to early diagnosis, antibiotic treatment, and surgical care continues to drive high rates of advanced valvular disease in these regions.
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