The evolution of minimally invasive mitral valve surgery – 2 year experience1
Key result
Transitioning to a robot-assisted solo surgery approach for minimally invasive mitral valve surgery reduced hospital mortality to 3.0% and improved mean survival to 97.0% vs 88.7% initially.
Why the study?
Does a simplified solo surgical technique using voice-controlled robotic assistance improve outcomes and procedural times compared to initial minimally invasive mitral valve surgery in patients with non-ischemic mitral valve disease?
Population
129 patients with non-ischemic mitral valve disease undergoing minimally invasive mitral valve surgery
Comparison
Simplified solo surgical technique using… vs Initial series of 3D-video assisted mitral valve…
Design
Cohort
Follow-up
Group I: 804 +/- 35 days; Group II: 568 +/- 12 days
Authors
Discussion
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Member takes
Implication
Suggests voice-controlled robotic assistance is a feasible alternative to standard minimally invasive mitral surgery; leaves open.
Key Points
- Evaluate the clinical progression and outcomes of Port-Access minimally invasive mitral valve surgery transitioning to a voice-controlled, robot-assisted solo surgical technique.
- N=129 patients with non-ischemic mitral valve disease underwent 3D-video assisted surgery through a 4 cm right lateral minithoracotomy with femoro-femoral bypass and endoaortic clamping monitored by transesophageal echocardiography.
- The cohort was divided into an initial series (Group I, n=62) and a subsequent group using a voice-controlled robotic arm (AESOP 3000) for endoscope guidance as a solo operator (Group II, n=67).
- In Group II, the solo surgical approach achieved mean cardiopulmonary bypass and cross-clamp times of 107 ± 34 min and 48 ± 16 min, respectively, with 72 total repairs across the overall cohort.
- Hospital mortality declined from Group I (mean survival 88.7% at 804 ± 35 days; 95% CI: 735–873) to 3.0% in Group II (mean survival 97.0% at 568 ± 12 days; 95% CI: 553–600).
Study Design
Type
Cohort (n=129)
Structured PICO
Does a simplified solo surgical technique using voice-controlled robotic assistance improve outcomes and procedural times compared to initial minimally invasive mitral valve surgery in patients with non-ischemic mitral valve disease?
P
Population
129 patients with non-ischemic mitral valve disease undergoing minimally invasive mitral valve surgery
I
Intervention
Simplified solo surgical technique using voice-controlled robotic assistance (AESOP 3000) for videoscope guidance (n=67)
C
Comparator
Initial series of 3D-video assisted mitral valve surgery without robotic solo assistance (n=62)
O
Outcome
Procedural times (bypass and clamp time), hospital mortality, and survivalhard clinical
Main Result
Absolute Event Rate: 97% vs 88.7%
Robotic-assisted solo minimally invasive mitral valve surgery is feasible, reduces the need for an additional assistant, and is associated with low hospital mortality after an initial learning curve.
Cite This Study
Mohr et al. (1999) conducted a cohort in non-ischemic mitral valve disease (n=129). Robot assisted video assisted solo surgery vs. Initial series of Port-Access minimally invasive mitral valve surgery was evaluated on Mean survival. Transitioning to a robot-assisted solo surgery approach for minimally invasive mitral valve surgery reduced hospital mortality to 3.0% and improved mean survival to 97.0% vs 88.7% initially.