Robotic Mitral Valve Repair With Severe Pectus Excavatum

Figures

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  Visual Summary. Robotic Mitral Repair With Pectus Excavatum MR = mitral regurgitation.

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  Figure 1. Preoperative Chest Computed Tomography for Patient 1 Severe pectus excavatum with maximum Haller index of 7.2, worst just below xiphisternal junction.

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  Figure 2. Preoperative Chest Computed Tomography for Patient 2 Moderate pectus excavatum with a maximum Haller index of 3.2.

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  Figure 3. Preoperative Chest Computed Tomography for Patient 3 Moderate pectus excavatum with maximum Haller index of 3.2.

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  Figure 4. Standard Robotic Port Placement for Mitral Surgery, Used for Patients 2 and 3 Limited (∼2 and 4 cm) fourth interspace anterolateral thoracotomy in approximately the midaxillary line, with lateral 8-mm arm ports in the third, fourth, and sixth interspaces and a medial port in the fourth space for the left atrial retractor.

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  Figure 5. Robotic Port Placement for Patient 1 Third interspace working port, with 8-mm ports in the second, third, and fifth interspaces. Access was shifted up one rib space and targeted inferiorly given severe pectus deformity at the inferior border of the patient's heart.