Key result
Complex bileaflet robotic mitral valve repair for Barlow's disease achieves zero postoperative MR.
Why the study?
Robotic mitral valve repair is less invasive and potentially more precise, but it lengthens cardiopulmonary bypass and arrested heart times, with initial experience limited to posterior leaflet repair and annuloplasty.
Can complex bileaflet mitral valve repair for Barlow's disease be successfully performed using the da Vinci Robotic Surgical System?
Case Report (n=1)
Can complex bileaflet mitral valve repair for Barlow's disease be successfully performed using the da Vinci Robotic Surgical System?
Complex bileaflet mitral valve repair for Barlow's disease can be successfully performed using a robotic surgical system, though long-term durability requires further study.
Robotic bileaflet repair is feasible in Barlow's disease; leaves open durability and generalizability.
Robotic mitral valve repair (RMVR) is less invasive and potentially more precise. However, RMVR lengthens both cardiopulmonary bypass and arrested heart times. In our initial experience, only posterior leaflet repair and/or annuloplasty were performed. With increasing experience, we have performed more complex bileaflet RMVR. A 50-year-old man presented with severe mitral regurgitation. Transesophageal echocardiography (TEE) demonstrated a complex bileaflet prolapse and preserved left ventricular function. Through a 4 cm working port and with the da Vinci Robotic Surgical System (Intuitive Surgical, Sunnyvale, CA) RMVR was performed. Details of the technique and patient's hospital course are described. The repair comprised closure of clefts between A3 and P3, quadrangular resection of P2, transfer of multiple chords from P2 to A2/A3 and a #38 Cosgrove-Edwards (Edwards Lifesciences, Irvine, CA) band annuloplasty. Nitinol U-Clips (Medtronic, Minneapolis, MN) were used to complete the annuloplasty. Postoperative TEE showed no mitral regurgitation. The patient was discharged on the third postoperative day. Cardiopulmonary bypass and arrested heart times were 3 hours and 29 minutes and 2 hours and 59 minutes, respectively. Complex bileaflet repair of mitral valve with Barlow's disease can be successfully performed with the da Vinci Robotic Surgical System. Long-term follow-up is needed to assess the durability of repair.
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Masroor et al. (2006) conducted a case report in Severe mitral regurgitation (Barlow's disease) (n=1). Complex bileaflet robotic mitral valve repair (RMVR) using the da Vinci Robotic Surgical System was evaluated on Postoperative mitral regurgitation. Complex bileaflet repair of the mitral valve with Barlow's disease was successfully performed using the da Vinci Robotic Surgical System, resulting in no postoperative mitral regurgitation.
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