Conclusion:
Despite an inherent learning curve, minimally invasive MV surgery
guarantees a clinical outcome and MV repair quality, at least
non-inferior to those of MV surgery via sternotomy. Notwithstanding
longer cardiopulmonary bypass and cardiac arrest times, the impact on
secondary organ function is negligible, excepted for a lower systemic
inflammatory response. The postoperative increase of CK-enzymes
suggestive for enhanced rhabdomyolysis needs to be accounted when
procedural times tend to exceed the critical time threshold for severe
limb ischemia.