Key result
Robotic beating heart mitral valve surgery proves feasible in high-risk patients with 0 conversions to sternotomy.
Why the study?
Robotic mitral valve surgery is challenging in patients unsuitable for aortic cross-clamping, and the feasibility and benefits of robotic beating heart surgery were unclear.
Is robotic beating heart mitral valve surgery feasible and safe in patients not suitable for aortic cross-clamping?
Observational (n=17)
Is robotic beating heart mitral valve surgery feasible and safe in patients not suitable for aortic cross-clamping?
Robotic beating heart mitral valve surgery is a feasible technique with favorable early and mid-term results for patients unsuitable for aortic cross-clamping.
May expand options for reoperative mitral patients unsuitable for clamping; leaves open need for comparative trials.
INTRODUCTION: Robotic mitral valve surgery is a challenging issue, particularly in patients who are not suitable for aortic cross-clamping. In this study, we aimed to determine the feasibility and benefits of robotic, beating heart mitral valve surgery. METHODS: From February 2019 to February 2022, 17 patients underwent robotic beating heart mitral valve surgery. Fourteen of the patients had previous cardiac surgery. The mean age was 58.1 ± 10.3. Dense periaortic adhesions, heavily calcified aorta, and low ejection fraction were retained as indications for beating heart surgery. RESULTS: Mitral valve replacement was performed in 14 patients. Mitral ring annuloplasty was performed in two patients with low ejection fraction (EF). A severe paravalvular leak was repaired in one patient. Additional tricuspid annuloplasties were performed in three patients. Cardiopulmonary bypass time were 185.6 ± 55 min. There were no cases of conversion to sternotomy or thoracotomy. No cerebrovascular event occurred in the follow-up. One patient died as a result of secondary hepatorenal syndrome and multiorgan failure. CONCLUSIONS: Robotic beating heart mitral valve surgery is a feasible and effective technique with favorable early and mid-term results, especially in patients who are not suitable for aortic cross-clamping, secondary to periaortic adhesions, severe aortic calcifications, and low ejection fraction.
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Bolcal et al. (2022) conducted an observational in Mitral valve disease requiring surgery (n=17). Robotic beating heart mitral valve surgery was evaluated on Feasibility and clinical outcomes (conversion to sternotomy, cerebrovascular events, mortality). Robotic beating heart mitral valve surgery was feasible in 17 high-risk patients, resulting in 0 conversions to sternotomy, 0 cerebrovascular events, and 1 death.
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