Short- and Mid-Term Outcomes of Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation in Octogenarians

Background: Robotic mitral valve repair (r-MVr) offers potential advantages, but its safety and feasibility in patients aged ≥80 years remain unclear. Methods and Results: This single-center retrospective cohort study included 53 consecutive patients aged ≥80 years who underwent MVr for degenerative mitral regurgitation between April 2011 and July 2025: 31 patients underwent r-MVr using the da Vinci Xi system, and 22 underwent conventional MVr (c-MVr). The primary outcomes were 30-day mortality, major complications, lengths of intensive care unit and hospital stay, and postoperative echocardiography findings. One 30-day death occurred after r-MVr (3.2%) due to intestinal ischemia, and none occurred after c-MVr. The postoperative hospital stay was shorter after r-MVr (12 [interquartile range (IQR), 8-13] vs. 13 [IQR, 12-15] days; P=0.04). The transmitral pressure gradient was lower in the r-MVr group than in the c-MVr group (2.1 [IQR, 2.0-3.0] vs. 3.0 [IQR, 2.0-3.9] mmHg; P=0.02). At the mid-term follow-up, there were no significant differences between the groups in 5-year overall survival (83.3% vs. 95.2%; P=0.32) or freedom from recurrent mitral regurgitation ≥ grade 3 (95.2% vs. 100%; P=0.49). Conclusions: r-MVr can be a safe and feasible minimally invasive option with acceptable short- and mid-term outcomes in octogenarians.