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. 2024 Jun 26;13(13):3744.
doi: 10.3390/jcm13133744.

Robotic Mitral Valve Repair: Impact of Experience on Results and Complex Mitral Disease Treatment

Antonio Lio  1 , Marco Russo  1 , Beatrice Sangiorgi  1 , Francesca Nicolò  1 , Ilaria Chirichilli  1 , Francesco Irace  1 , Federico Ranocchi  1 , Francesco Musumeci  1
Affiliations

Robotic Mitral Valve Repair: Impact of Experience on Results and Complex Mitral Disease Treatment

Antonio Lio et al. J Clin Med. .

Abstract

Background/Objectives: Robotically assisted mitral valve (MV) surgery is the least invasive surgical approach to the MV. The aim of the present study is to report our experience with robotically assisted MV repair, trying to define how experience could impact on postoperative results. Methods: This is a retrospective study on 144 patients who underwent robotic MV repair from November 2011 to March 2023. Patients were divided in two groups: Group 1, including 39 patients (November 2011-January 2013) operated using the Da Vinci Si system, and Group 2, including 105 patients operated (February 2020-March 2023) using the new Da Vinci Xi system. Results: Mean age was 58 ± 10 years. Increased use of external aortic clamp was observed in Group 2. A significant reduction of surgical times was observed: cardiopulmonary bypass time was 155 ± 44 min in Group 1 and 121 ± 36 min in Group 2 (p = 0.002), whereas cross-clamp time was 112 ± 25 min in Group 1 and 68 ± 39 min in Group 2 (p < 0.001). In-hospital mortality was 0.7%, and 10-year survival was 96 ± 2%. Freedom from reoperation was 100%. A higher percentage of complex and most complex MV repairs were performed in Group 2 (36% in Group 1 vs. 52% in Group 2, p = 0.001). Conclusions: Robotic-assisted MV repair is associated with excellent results. Experience is a key element to overcome the limitations of this technology. Finally, the robotic platform could improve results in difficult MV repair.

Keywords: minimally invasive; mitral valve; mitral valve repair; robotic surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curve of overall survival.
Figure 2
Figure 2
Distribution of MV complexity in all patients using Loulmet classification.
Figure 3
Figure 3
Distribution of MV complexity in Group 1 and Group 2 patients using Loulmet classification.
See this image and copyright information in PMC

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