Complex repair of a Barlow's valve using the Da Vinci robotic surgical system

Robotic mitral valve repair is increasingly being used for mitral valve repair. However, the repair of a bileaflet prolapse (especially Barlow's type) is difficult and not often considered suitable for a robotic-assisted approach. The case is reported of a successful robotic-assisted repair of a Barlow's valve, including posterior leaflet resection, chordal transfer, cleft repair, construction of Gore-Tex neo-chords, bilateral commissuroplasties, and a flexible/partial annuloplasty. The total cardiopulmonary bypass and cross-clamp times were 231 and 183 min, respectively. The patient was discharged home on the third postoperative day and is doing well one year later, with no residual mitral regurgitation.