{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T19:03:59Z","timestamp":1789326239569,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to compare early and late postoperative clinical outcomes between minimally invasive surgery (MIS) and full sternotomy (FS) in patients with mitral valve (MV) infective endocarditis (IE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This meta-analysis was conducted in compliance with the PRISMA guidelines. PubMed, Scopus, and Web of Science databases were searched for any randomized control trials or cohort studies that compared MIS versus FS in surgery for mitral valve infective endocarditis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four cohort studies with 466 patients (137 in MIS group and 329 in FS group), were included in our study. Pooled analysis showed no significant difference between MIS and FS in terms of in-hospital\/30-day mortality (RR = 0.71, 95% CI [0.31-1.60],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.40), stroke (RR = 0.63, 95% CI [0.16-2.46],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.50), atrial fibrillation (RR = 0.89, 95% CI [0.57-1.40],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.62), acute kidney injury\/renal failure (RR = 0.51, 95% CI [0.22-1.16],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.11), multi-organ failure (RR = 0.94, 95% CI [0.33-2.70],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.90), and readmission rates (RR = 0.75, 95% CI [0.39-1.45],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.39). However, our study showed a statistically significant association between MIS and lower risk of postoperative sepsis (RR = 0.17, 95% CI [0.03-0.84],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.03), fewer blood transfusions (RR = 0.63, 95% CI [0.48-0.84],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value = 0.001), and shorter length of ICU stay (RR = \u22121.57, 95% CI [\u22122.16, \u22120.97],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value &lt;0.00001) compared to FS. The pooled effect estimate showed no significant difference between both groups in terms of need for reoperation, permanent pacemaker implantation, survival up to 2.5 years, and IE recurrence up to 3.5 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that MIS may be a safe and cost-effective alternative for FS in patients undergoing surgery for mitral valve infective endocarditis. Surgical approach should be tailored to the patient\u2019s clinical risk profile, the extent of endocarditis, and the team\u2019s experience, to ensure optimal clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591261488628","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:00:21Z","timestamp":1789113621000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally invasive approach versus median sternotomy in patients undergoing surgery for mitral valve infective endocarditis, a meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9861-5980","authenticated-orcid":false,"given":"Karam R.","family":"Motawea","sequence":"first","affiliation":[{"name":"University Hospitals Cleveland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Blackledge","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abed M.","family":"Al-Sheikh","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Case Western Reserve University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"El Diasty","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakov","family":"Elgudin","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Joseph F.","family":"Sabik","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasir","family":"Abu-Omar","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05422-8"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.11.017"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13577"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2019.10.05"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112843"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad271"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.01.106"},{"issue":"46","key":"e_1_3_4_9_2","first-page":"777","article-title":"The opportunities and limitations of minimally invasive cardiac surgery","volume":"114","author":"Doenst T","year":"2017","unstructured":"Doenst T, Diab M, Sponholz C, et al. The opportunities and limitations of minimally invasive cardiac surgery. Dtsch Arztebl Int 2017; 114(46): 777\u2013784. https:\/\/doi.org\/10.3238\/arztebl.2017.0777","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.08.006"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab364"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases13050135"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2025.01.023"},{"issue":"3","key":"e_1_3_4_16_2","first-page":"343","article-title":"Right anterior minithoracotomy versus median sternotomy surgery for native mitral valve infective endocarditis","volume":"23","author":"Mihos CG","year":"2014","unstructured":"Mihos CG, Santana O, Pineda AM, et al. Right anterior minithoracotomy versus median sternotomy surgery for native mitral valve infective endocarditis. J Heart Valve Dis 2014; 23(3): 343\u2013349.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/imi.0b013e3182167feb"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjco.2025.04.072"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.04.038"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)02070-1"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(03)00078-3"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000137141.55267.47"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199710000-00003"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14062087"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13239-015-0210-5"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003155"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.8653"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.001402"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.08.025"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025433"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-016-0977-9"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261488628","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591261488628","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261488628","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T18:23:25Z","timestamp":1789323805000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591261488628"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":30,"alternative-id":["10.1177\/02676591261488628"],"URL":"https:\/\/doi.org\/10.1177\/02676591261488628","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"02676591261488628"}}