Robotic-assisted mitral valve repair demonstrated favorable mid-term outcomes, with a 5-year overall survival rate of 97.4%, 5-year freedom from reoperation of 95.0%, and 5-year freedom from moderate or worse mitral regurgitation of 86.0%.
Systematic Review (n=3,300)
Yes
Does robotic mitral valve repair provide favorable mid-term survival, freedom from reoperation, and freedom from recurrent MR in patients with mitral valve disease?
Robotic mitral valve repair is a safe procedure with low early complication rates and favorable mid-term overall survival, freedom from reoperation, and freedom from recurrent mitral regurgitation.
Background: Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term data for RMVr. Methods: Electronic searches of five databases were performed to identify all relevant studies reporting minimum five-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and from moderate or worse mitral regurgitation (MR) at five years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Results: Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-year were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at eight-years post RMVr was 95.0%. Freedom from moderate or worse MR at seven years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. Conclusions: RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and from moderate or worse MR recurrence.
Williams et al. (Fri,) conducted a systematic review in Mitral valve disease (n=3,300). Robotic-assisted mitral valve repair (RMVr) was evaluated on 5-year overall survival. Robotic-assisted mitral valve repair demonstrated favorable mid-term outcomes, with a 5-year overall survival rate of 97.4%, 5-year freedom from reoperation of 95.0%, and 5-year freedom from moderate or worse mitral regurgitation of 86.0%.