Key result
Robotic-assisted endoscopic excision of cor triatriatum sinistrum successfully relieves exertional symptoms in a single patient.
Why the study?
Surgical correction of cor triatriatum sinistrum has traditionally used sternotomy with cardioplegic arrest, with limited experience in totally endoscopic robotic approaches under ventricular fibrillation.
Is totally endoscopic robotic repair under ventricular fibrillation feasible and effective for adult cor triatriatum sinistrum?
Case Report (n=1)
No
Is totally endoscopic robotic repair under ventricular fibrillation feasible and effective for adult cor triatriatum sinistrum?
This case demonstrates the feasibility of a fully endoscopic robotic approach utilizing transvenous ventricular fibrillation instead of aortic cross-clamping for the surgical correction of cor triatriatum sinistrum in adults.
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“The successes never stop. I am very proud of this team. We're fundamentally changing how heart surgery is done, but also changing access to care.”
Single-case robotic repair under ventricular fibrillation merits prospective series; leaves open generalizability versus sternotomy and should not yet change practice.
BACKGROUND: Surgical correction of cor triatriatum sinistrum (CTS) has traditionally relied on conventional sternotomy with cardioplegic myocardial arrest. To date, there has been limited experience with totally endoscopic and robotic approaches, especially with ventricular fibrillation as an alternative to aortic cross-clamping and cardioplegic arrest. FIH: A 57-year-old man with dyspnea was found to have CTS without significant resting transmitral obstruction. Stress echocardiography and invasive hemodynamics revealed marked exercise-induced pulmonary hypertension. Given the abnormal stress physiology, surgical treatment through a totally endoscopic, robotic-assisted excision of the left intra-atrial membrane was performed using the Da Vinci Xi platform under controlled ventricular fibrillation induced by transvenous pacing. Complete resection was confirmed intraoperatively, and follow-up imaging demonstrated improved pulmonary pressures. NOVELTY: This case demonstrates the feasibility of a totally endoscopic, robotic-assisted strategy for CTS treatment performed under ventricular fibrillation. TAKE-HOME MESSAGE: Correction of CTS is feasible using a totally endoscopic and robotic-assisted approach.
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Bisleri et al. (2026) conducted a case report in Cor triatriatum sinistrum (n=1). Totally endoscopic, robotic-assisted excision of the left intra-atrial membrane under ventricular fibrillation was evaluated on Surgical feasibility, intraoperative resection, and postoperative symptomatic relief. Totally endoscopic, robotic-assisted excision of a cor triatriatum sinistrum membrane under ventricular fibrillation was feasible and improved exertional symptoms in a 57-year-old man.
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