{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:51:52Z","timestamp":1777737112052,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Sharpe - Strumia Research Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Since there are concerns about the durability of mitral valve repair (MVRp) with minimally invasive techniques in patients with mitral regurgitation (MR), we aimed to evaluate the long-term outcomes of these sternal-sparing approaches when compared with conventional approaches with sternotomy in patients undergoing MVRp.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a systematic review according to a preestablished protocol and performed a pooled analysis of Kaplan\u2013Meier\u2013derived reconstructed time-to-event data from studies with longer follow-up comparing sternal-sparing versus sternotomy approaches for MVRp. Our outcomes of interest were survival, freedom from recurrent MR, and freedom from reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Eleven studies met our eligibility criteria comprising 7,596 patients with follow-up (sternal sparing,\n                      <jats:italic>n<\/jats:italic>\n                      = 4,246; sternotomy,\n                      <jats:italic>n<\/jats:italic>\n                      = 3,350). Patients who underwent sternal-sparing MVRp had a significantly lower risk of mortality over time compared with patients who underwent MVRp with sternotomy (hazard ratio [HR] = 0.29, 95% confidence interval [CI]: 0.23 to 0.36,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) in the overall analysis. However, we found no statistically significant difference between the groups in the sensitivity analysis with adjusted populations (HR = 0.85, 95% CI: 0.63 to 1.15,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.301). Regarding the outcomes freedom from recurrent MR and freedom from reoperation, we found no statistically significant differences between the groups in the follow-up in both overall and sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In comparison with MVRp with sternotomy approaches, sternal-sparing MVRp was not associated with worse outcomes in terms of survival, recurrent MR, and reoperations over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845231166902","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T06:21:23Z","timestamp":1683008483000},"page":"167-174","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-Term Outcomes of Sternal-Sparing Versus Sternotomy Approaches for Mitral Valve Repair: Meta-Analysis of Reconstructed Time-to-Event Data"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2996","authenticated-orcid":false,"given":"Michel Pompeu","family":"S\u00e1","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8421-0686","authenticated-orcid":false,"given":"Xander","family":"Jacquemyn","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozgun","family":"Erten","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jef","family":"Van den Eynde","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tulio","family":"Caldonazo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Doenst","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Medizinische Hochschule Hannover (MHH), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Weymann","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Medizinische Hochschule Hannover (MHH), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo Oliveira Rosa Ribeiro","family":"de Souza","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of South Florida, USF Health, Tampa, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basel","family":"Ramlawi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA, USA"},{"name":"Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, 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