Key result
Robotic mitral valve repair shows ~96% 10-year survival, with increased experience reducing surgical times.
Why the study?
The impact of surgical experience on costs, postoperative results, and treatment of complex mitral valve disease using robotic mitral valve repair was not well defined.
Does experience and a newer robotic platform (Da Vinci Xi) improve surgical times and allow for more complex repairs compared to an older system (Da Vinci Si) in patients undergoing robotic mitral valve repair?
Cohort (n=144)
No
Does experience and a newer robotic platform (Da Vinci Xi) improve surgical times and allow for more complex repairs compared to an older system (Da Vinci Si) in patients undergoing robotic mitral valve repair?
Absolute Event Rate: 1% vs 0%
p-value: p=ns
Increased experience and newer robotic platforms in mitral valve repair are associated with significantly reduced surgical times and the ability to perform more complex repairs, while maintaining excellent long-term survival.
May support robotic mitral repair in experienced centers; leaves open need for randomized comparison to conventional techniques.
Background. Robotically assisted mitral valve (MV) surgery is the least invasive surgical approach to the MV. The aim of the present study is to report 10-year experience with robotically assisted MV repair trying to define how experience could impact on costs and postoperative results.Methods. Retrospective study on 144 patients who underwent robotic MV repair from November 2011 to March 2023. Patients were divided in two groups: Group 1, including 39 patients (November 2011- January 2013) operated using the Da Vinci Si system and Group 2, including 105 patients operated (February 2020 - March 2023) using the new Da Vinci Xi system.Results. Mean age was 58 ± 10 years. Increased use of external aortic clamp was observed in Group 2. A significant reduction of surgical times was observed: cardiopulmonary bypass time was 155 ± 44 minutes in Group 1 and 121 ± 36 minutes in Group 2 (P = 0.002), whereas cross-clamp time was 112 ± 25 minutes in Group 1 and 68 ± 39 minutes in Group 2 (P < 0.001). In-hospital mortality was 0.7%. 10-year survival was 96 ± 2%. Freedom from reoperation was 100%. A higher percentage of complex and most complex MV repairs were performed in Group 2 (36% in Group 1 vs 52% in Group 2, P = 0.001).Conclusion. Robotic assisted MV repair is associated with excellent results. Experience is a key element to overcome the limitations of this technology, including costs. Finally, the robotic platform could improve results in difficult MV repair.
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Lio et al. (2023) conducted a cohort in Mitral valve disease requiring repair (n=144). Later robotic mitral valve repair experience (Da Vinci Xi system) vs. Early robotic mitral valve repair experience (Da Vinci Si system) was evaluated on Operative mortality (p=ns). Robotic assisted mitral valve repair was associated with 0.7% overall in-hospital mortality, 96% 10-year survival, and 100% freedom from reoperation, with increased experience significantly reducing surgical times.
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