Minimally invasive mitral repair surgery: why does controversy still persist?

Surgical treatment for mitral valve disease has evolved and remains a rapidly expanding field. Minimally invasive mitral valve repair (MI-MVR) is a well-known alternative to conventional sternotomy mitral valve repair (cMVR). However, controversy as to the efficacy of MI-MVR persists, hindering the adoption and potential benefits of this less invasive approach. Areas covered: In this review, we provide an updated summary evaluation of the latest evidence, including observational studies, clinical trials and meta-analyses, regarding MI-MVR in comparison to cMVR. Expert commentary: The controversy that persists around the widespread adoption of MI-MVR procedures is addressed with the wealth of evidence published establishing similarly excellent outcomes between MI-MVR and cMVR.