Feasibility, Safety and Quality of Complex Mitral Valve Repair in the Early Phase of a Robotic Surgery Programme

Overview

Journal Interdiscip Cardiovasc Thorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2024 Nov 19

PMID 39558609

Authors

Kei Kobayashi

Yizhan Guo

Thomas E Rubino Jr

Luis E Ramirez

Stephen D Waterford

Ibrahim Sultan

Victor D Morell

Johannes Bonatti

Affiliations

Soon will be listed here.

Abstract

Objectives: To evaluate the feasibility, safety and quality of robotic-assisted mitral valve repair in complex versus non-complex cases during the early phase of a programme.

Methods: Since the programme launch in September 2021 until February 2024, 100 patients underwent robotic-assisted mitral valve repair. Of them, 21 patients had complex repairs, while 79 had non-complex repairs. The median age was 58 years for complex cases and 61 years for non-complex cases (P = 0.36).

Results: Bileaflet prolapse was significantly more prevalent in the complex group (52.4% vs 12.7%, P < 0.001). Neochord placement (61.9% vs 13.9%, P < 0.001) and commissuroplasty (28.6% vs 5.1%, P = 0.005) were more frequent in the complex group. The complex group had longer cardiopulmonary bypass times (161 vs 141 min, P < 0.001), aortic cross-clamp times (123 vs 102 min, P < 0.001) and leaflet repair times (43 vs 24 min, P < 0.001). Second pump runs were required more often for complex cases (23.8% vs 3.8%, P = 0.01). All patients left the operating room with residual mitral regurgitation of mild or less. Fewer complex patients were extubated in the operating room (42.9% vs 70.9%, P = 0.02), yet hospital stay was similar (4 vs 4 days, P = 0.56). There were no significant differences in postoperative adverse events. There were no differences in mitral regurgitation of mild or less 4 weeks post-surgery (95.2% vs 98.7%, P = 0.47).

Conclusions: Complex mitral valve repair can be safely and effectively performed with robotic assistance, even in the early phase of a programme. Despite longer operative and ventilation times in the complex group, hospital stay and postoperative adverse events remained similar.

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