Methods: A retrospective analysis was conducted on consecutive minimally i nvasive a nd c onventional m itral v alve s urgeries performed between January 2019 and December 2022. Patients undergoing concomitant procedures were excluded from the study, and 293 patients (149 females, 144 males; mean age: 53.8±12.9 years; range, 18 to 82 years) were included in the study. Of these patients, 96 underwent minimally invasive surgery (MI group), and 197 underwent mitral valve surgery via conventional sternotomy (CS group). Propensity score matching was utilized to minimize the biases and confounding factors. After propensity score matching, 55 patients were included in each group.

Results: There was no statistically significant difference in terms of mortality between the propensity score-matched groups (p=0.315), and no statistically significant difference in postoperative complications was observed between the groups. However, it was found that postoperative new-onset atrial fibrillation was lower in the minimally invasive group (p=0.022).

Conclusion: This study demonstrates that minimally invasive mitral valve surgery is a safe alternative with similar mortality and postoperative complication rates compared to conventional surgery. Additionally, the study suggests an association between minimally invasive surgery and postoperative new onset atrial fibrillation.