Minimally Invasive Thoracoscopically-Guided Right Minithoracotomy Versus Conventional Sternotomy for Mitral Valve Repair: The UK Mini Mitral Multicentre RCT

The UK Mini Mitral Trial compared minimally invasive (Mini) mitral valve repair (MVr) to conventional sternotomy in patients with degenerative mitral regurgitation. The primary objective was to assess physical function (PF) recovery, using the Short Form 36-Item Health Survey, version 2 (SF-36v2) PF scale 12 weeks post-surgery. The trial found no significant difference in PF between the two approaches. Although the Mini approach was more costly, it had higher quality-adjusted life years (QALYs) and a low probability of being cost-effective compared to sternotomy. Both groups had high valve repair rates and low recurrent mitral regurgitation. Hospital stay was shorter for the Mini approach, with a higher proportion of early discharges. Safety outcomes were similar across both procedures. The trial suggests that the Mini approach offers durable repairs with comparable safety but no clear advantage in PF recovery.