The Effect of Minimally Invasive Surgery and Sternotomy on Physical Activity and Quality of Life

Marco Moscarelli*, Roberto Lorusso, Yusuf Abdullahi, Egidio Varone, Marco Marotta, Marco Solinas, Roberto Casula, Alessandra Parlanti, Giuseppe Speziale, Khalil Fattouch, Thanos Athanasiou

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)


Aim The aim of this study was to compare minimally invasive surgery (MI) and median sternotomy (MS) in terms of post-procedure health-related quality of life (HRQoL) and functional outcome.

Method We conducted a multicentre prospective cohort study that enrolled patients from January 2015 until February 2017. Combined cardiac procedures were performed with MS and isolated valve procedures with either MS or MI, depending on patient preference and surgeon experience. HRQoL was measured using the five-level version of the EQ-5D (EQ-5D-5L) and physical activity before and after surgery was evaluated using a wearable accelerometer. Activity patterns and intensity recorded by the accelerometer in each period were classified as "sedentary", "light physical activity", "moderate physical activity", and "vigorous physical activity" for each patient. We also conducted a sub-analysis of frail patients in each group, as identified by the Reported Edmonton Frail Scale (>10 points). Patients were followed for 1 year.

Results The study included 100 consecutive patients who underwent MI (n=50) or MS (n=50) during the study period. Patients in the MI group showed a faster recovery of physical activity in the immediate postoperative period and superior HRQoL in the first 3 months (both p

Conclusions Compared to conventional MS, MI was associated with better HRQoL and early functional outcome, even in frail patients.

Original languageEnglish
Pages (from-to)882-887
Number of pages6
JournalHeart Lung and Circulation
Issue number6
Publication statusPublished - Jun 2021


  • Conventional sternotomy
  • Functional outcome
  • Health-related quality of life
  • Minimally invasive valve surgery

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