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Objectives: Mitral valve (MV) disease is often accompanied by tricuspid valve (TV) disease. The indication for concomitant TV surgery during primary MV surgery is expected to increase, especially through a minimally invasive surgical (MIS) approach. The aim of the current study is to investigate the safety of the addition of TV surgery to MV surgery in MIMVS in a nationwide registry. Methods: Patients undergoing atrioventricular valve surgery through sternotomy or MIS between 2013 and 2018 were included. Patients undergoing MV surgery only through sternotomy or MIS were used as comparison. Primary outcomes were short‐term morbidity and mortality and long‐term survival. Propensity score matching was used to correct for potential confounders. Results: The whole cohort consisted of 2698 patients. A total of 558 patients had atrioventricular double valve surgery through sternotomy and 86 through MIS. As a comparison, 1365 patients underwent MV surgery through sternotomy and 689 patients through MIS. No differences in 30‐ and 120‐day mortality were observed between the groups, both unmatched and matched. 5‐year survival did not differ for double atrioventricular valve surgery through either sternotomy or MIS in the matched population (90.1% vs. 95.3%, Log‐Rank p =.12). A higher incidence of re‐exploration for bleeding (n = 12 [15.2%] vs. n = 3 [3.8%], p =.02) and new onset arrhythmia (n = 35 [44.3%] vs. n = 13 [16.5%], p <.001) was observed in double valve surgery through MIS. Median length of hospital stay (LOHS) was longer in the minimally invasive double valve group (9 days [6–13]) compared with sternotomy (7 days [6–11]; p =.04). Conclusion: No differences in short‐term mortality and 5‐year survival were observed when tricuspid valve was added to MV surgery in MIS or sternotomy. The addition of tricuspid valve surgery is associated with higher incidence of re‐exploration for bleeding, new onset arrhythmia. A longer LOHS was observed for MIS compared to sternotomy. [ABSTRACT FROM AUTHOR]

In the past few years, many have disputed the optimal biomarker for confirming or ruling out a diagnosis of periprocedural myocardial infarction (PMI) and the optimal cut‐off concentrations to apply. In this issue of the Journal of Cardiac Surgery, Niclauss et al. performed a retrospective analysis of CK‐MB and high‐sensitivity cardiac troponin T (hs‐cTnT) dynamics and peak concentrations following different cardiac surgical interventions in 400 patients during a 2‐year period in a single center. The authors found that CK‐MB and hs‐cTnT predict PMI with a comparable diagnostic accuracy and discriminatory power >95%. They also attempted to propose an improved, more sensitive threshold of hs‐cTnT for PMI. Their findings could have implications for clinical practice, but more research is warranted to identify more appropriate cut‐offs. This could include hs‐cTnT release pattern, slope steepness, and changes. Ultimately, this could results in patient‐specific model, able to predict expected and abnormal ranges of hs‐cTnT release, enabling an improved and timely diagnosis of PMI. [ABSTRACT FROM AUTHOR]