Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005;32(2):143-6.

Robotic mitral valve repair: a community hospital experience

Bruce A Jones  1 , Steve Krueger, Derek Howell, Barbara Meinecke, Shannon Dunn
Affiliations

Robotic mitral valve repair: a community hospital experience

Bruce A Jones et al. Tex Heart Inst J. 2005.

Abstract

Robotically assisted cardiac surgery has been presented as less invasive than conventional surgery, with shortened hospital stays and faster return to daily activities. We evaluated our experience with the da Vinci robot to determine whether we could in fact demonstrate those findings. All mitral and tricuspid valve repairs were performed by the same surgeon. Cardiopulmonary bypass was performed with femoral cannulation, antegrade cardioplegia, and transthoracic aortic cross-clamping. Multiple valve repair techniques were used, including quadrant resection, cord replacement, Alfieri leaflet coaptation, and ring annuloplasty. Access was by 2 ports and a 5-cm right anterolateral thoracotomy. All annuloplasty rings were secured using surgical clips. From October 2003 through September 2004, 32 patients underwent robotically assisted mitral valve repair. The mean age of our population was 676 years (range, 43-82 years). Four patients also underwent the 1st tricuspid valve repair using the da Vinci robot in the United States. There were 3 conversions for irreparable valves, 1 stroke, and 2 deaths. The average procedure time, cardiopulmonary bypass time, and aortic cross-clamp time were all reduced, when the first 20 patients were compared with the last 12. Length-of-stay also improved. One patient required early mitral valve replacement for recurrent regurgitation. Two patients required late (> 3 month) mitral valve replacement for recurrent regurgitation. We have shown that a dedicated nonacademic institute can develop a robotic cardiac surgery program and perform mitral and tricuspid valve repairs successfully. There is a several-case learning curve, and patient selection is paramount.

PubMed Disclaimer

Figures

None
Fig. 1 Typical positioning of a patient, with the 5-cm anterolateral mini-thoracotomy marked.
None
Fig. 2 Placement of an MC3 tricuspid annuloplasty band. First procedure using the robot recorded in the United States.
None
Fig. 3 Completed tricuspid repair, with use of the MC3 tricuspid annuloplasty band.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Loulmet DF, Carpentier A, Cho PW, Berrebi A, d'Attellis N, Austin CB, et al. Less invasive techniques for mitral valve surgery. J Thorac Cardiovasc Surg 1998;115:772–9. - PubMed
    1. Mohr FW, Onnasch JF, Falk V, Walther T, Diegeler A, Krakor R, et al. The evolution of minimally invasive valve surgery—2 year experience. Eur J Cardiothorac Surg 1999; 15:233–9. - PubMed
    1. Tatooles AJ, Pappas PS, Gordon PJ, Slaughter MS. Minimally invasive mitral valve repair using the da Vinci robotic system. Ann Thorac Surg 2004;77:1978–84. - PubMed
    1. United States Robotic Heart Surgery First Performed at BryanLGH Medical Center. Press Release; November 5, 2003.
    1. Bacchetta MD, Korst RJ, Altorki NK, Port JL, Isom OW, Mack CA. Resection of a symptomatic pericardial cyst using the computer-enhanced da Vinci Surgical System. Ann Thorac Surg 2003;75:1953–5. - PubMed