Heart consultant Enoch Akowuah has presented leading-edge research findings at the 2023 World Congress of Cardiology – putting UK cardiac surgery firmly back on the research map.
The UK Mini Mitral Trial – the largest randomised trial of its kind – showed similar recovery rates for heart valve surgery patients whether they underwent minimally invasive or conventional surgery.
Enoch, who led the trial of 330 patients across ten UK centres including The James Cook University Hospital, said: “Our results show that at three months physical recovery is equivalent in both groups of patients.
“In addition, we show that when both surgical procedures are performed by expert surgeons, minimally invasive mitral valve surgery is as safe and effective as conventional surgery.”
The prestigious event, hosted in partnership with the American College of Cardiology and the World Heart Foundation, was held in New Orleans, bringing together cardiologists and cardiovascular specialists from around the world to share the newest discoveries in treatment and prevention.
“This is the highest possible profile for the trial and will put UK cardiac surgery very firmly back on the research map,” said Enoch.
Patients in the study had severe degenerative mitral valve regurgitation, which occurs when the mitral heart valve doesn’t close completely, allowing blood to flow back into the left atrium of the heart, which can lead to serious complications such as blood clots, heart failure and stroke.
Conventional surgery to repair the mitral valve, via a sternotomy, involves opening the chest completely from the collarbone to the bottom of the breastbone. Recovery from conventional surgery generally takes about three months.
By contrast, the minimally invasive surgical procedure, known as a mini-thoracotomy, involves making an incision about two inches long in the chest to gain access to the heart and then using a camera and special instruments to repair the valve.
The study, funded by the National Institute of Health and Care Research, recorded changes in patients’ physical ability using questionnaires and a Fitbit-like device called an accelerometer.
Recovery of physical function levels after 12 weeks compared to pre-surgery levels was similar in both groups. However, at six weeks, patients in the mini-thoracotomy group had recovered physical function compared to pre-surgery levels, whereas patients in the sternotomy group had not.
Enoch added: “We hope that the results of this trial will give confidence to both clinicians and patients and drive uptake of the mini approach.”
