Sensitivity Analysis
To examine the possibility that these results were confounded by either a concurrent or previously coronary artery bypass grafting procedure, a separate analysis was conducted without these 25 patients. In this analysis, there was a less significant survival benefit on unadjusted Kaplan-Meier estimates of survival between surgical approaches (Log-Rank p = 0.05), however, a survival benefit was seen for the small right anterior thoracotomy approach on propensity adjusted multivariable Cox-Proportional hazard modeling (HR 0.341, 95% CI 0.12-0.96, p=0.04). Results similar to the primarily analyses were seen with the need for mitral reoperation and progression of MR outcomes (data not shown). No effect was seen in any adjusted analysis based on location of MVr (data not shown).