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. 2022 Oct;37(10):3267-3275.
doi: 10.1111/jocs.16849. Epub 2022 Aug 21.

Robotic vs. minimally invasive mitral valve repair: A 5-year comparison of surgical outcomes

Clark R Zheng  1 , Piotr Mazur  1 , Arman Arghami  1 , Sepideh Jahanian  1 , Jason K Viehman  2 , Katherine S King  2 , Joseph A Dearani  1 , Richard C Daly  1 , Phillip G Rowse  1 , Gabor Bagameri  1 , Juan A Crestanello  1
Affiliations

Robotic vs. minimally invasive mitral valve repair: A 5-year comparison of surgical outcomes

Clark R Zheng et al. J Card Surg. 2022 Oct.

Abstract

Background: Minimally invasive mitral valve repair (MVr) is commonly performed. Data on the outcomes of robotic MVr versus nonrobotic minimally invasive MVr are lacking. We sought to compare the short-term and mid-term outcomes of robotic and nonrobotic MVr.

Methods: We reviewed all patients who underwent robotic MVr (n = 424) or nonrobotic MVr via right mini-thoracotomy (n = 86) at Mayo Clinic, Rochester, MN, from January 2015 to February 2020. Data on baseline and operative characteristics, operative and long-term outcomes were analyzed. Patients were matched 1:1 using propensity scores.

Results: Sixty-nine matched pairs were included in the study. The median age was 59 years (interquartile range [IQR]: 54-69) and 75% (n = 103) were male. Baseline characteristics were similar after matching. Robotic and nonrobotic MVr had similar operative characteristics, except that robotic had longer cross-clamp times (57 [48-67] vs. 47 [37-58] min, p < .001) and more P2 resections (83% vs. 68%, p = .05) compared to nonrobotic MVr. There was no difference in operative outcomes between groups. Hospital stay was shorter after robotic MVr (4 [3-4] vs. 4 [4-6] days, p = .003). After a median follow-up of 3.3 years (IQR, 2.1-4.5), there was no mortality in either group, and there was no difference in freedom from mitral valve reoperations between robotic and nonrobotic MVr (5 years: 97.1% vs. 95.7%, p = .63). Follow-up echocardiogram analysis predicted excellent freedom from recurrent moderate-or-severe mitral regurgitation at 3 years after robotic and nonrobotic MVr (90% vs. 92%, p = .18, respectively).

Conclusions: Both short-term and mid-term outcomes of robotic and nonrobotic minimally invasive mitral repair surgery are comparable.

Keywords: valve repair/replacement.

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References

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