Key result
Robotic mitral valve replacement shows a low ~3% early mortality rate.
Why the study?
This study was conducted to evaluate the clinical outcomes of patients undergoing robotic mitral valve replacement (MVR) with or without additional cardiac procedures.
What are the perioperative and early 30-day clinical outcomes of robotic mitral valve replacement in patients with mitral valve disease requiring valve replacement?
Cohort (n=117)
No
What are the perioperative and early 30-day clinical outcomes of robotic mitral valve replacement in patients with mitral valve disease requiring valve replacement?
In a large single-center series of 117 patients, robotic mitral valve replacement—frequently combined with concomitant procedures—was feasible and safe, achieving an early 30-day mortality rate (2.6%) lower than predicted by EuroScore II (5.1%).
Answers are grounded in this paper and cite their sources.
Low early mortality and morbidity support feasibility of robotic mitral valve replacement; hypothesis-generating and requires randomized trials before practice change.
Background: This study evaluates the clinical outcome of patients with robotic mitral valve replacement (MVR). Methods: Between January 2010 and April 2022, 117 consecutive patients underwent robotic MVR with or without additional cardiac procedures. All procedures were completed by a single surgical team with Da Vinci Robotic Systems. Perioperative variables and early clinical outcomes were recorded. Results: Mean age and EuroScore II of the patients were 57.1±12.9 and 5.1±5.7, respectively. Isolated MVR was performed in 55 (47.0%) patients and combined cardiac procedures were performed in 62 (53.0%) patients. Additional procedures included: ablation for atrial fibrillation, tricuspid valve replacement, tricuspid valve repair, left atrial appendix ligation, patent foramen ovale closure, left atrial thrombectomy and septal myectomy for hypertrophic obstructive cardiomyopathy. Mean cardiopulmonary bypass time and cross clamp time were 143±54 and 93±37 minutes, respectively. Mean intensive care unit stay time was 26.5±26.0 hours. Postoperative stroke was observed in one (0.9%) patient and new onset renal failure was observed in two (1.7%) patients. Perioperative and postoperative early mortality was observed in three (2.6%) patients, which was lower than expected. Conclusions: Robotic MVR is feasible and can be performed with good early postoperative outcomes. A majority of the patients require additional cardiac procedures.
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Arslanhan et al. (2022) conducted a cohort in Mitral valve disease requiring mitral valve replacement (n=117). Robotic mitral valve replacement using Da Vinci XI or SI systems (isolated in 47.0%, with combined cardiac procedures in 53.0%) was evaluated on Perioperative and 30-day early mortality. Robotic mitral valve replacement resulted in a 2.6% early 30-day mortality rate, a 0.9% stroke rate, and a 1.7% new-onset renal failure rate in 117 patients.
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