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Updated: May 23, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Multicenter mitral valve study: a lateral approach using the da vinci surgical system.
Douglas Murphy1, J Michael Smith, Leland Siwek
1From *St. Joseph Hospital, Atlanta, GA; the †Department of Surgery, Good Samaritan Hospital, Cincinnati, OH; ‡Cardiac, Vascular, and Thoracic Surgeons, Inc, Cincinnati, OH; §Sacred Heart Medical, Spokane, WA; ‖Intuitive Surgical, Sunnyvale, CA; and ¶E. Kenneth Hatton, MD, Institute for Research and Education, Cincinnati, OH.
This study shows that a lateral endoscopic robotic approach for mitral valve repair is feasible and safe. The procedure achieved excellent repair rates and acceptable outcomes in 201 patients.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Robotic Surgery
Background:
- Mitral valve repair is a complex procedure.
- Minimally invasive approaches are gaining traction.
- Robotic surgery offers enhanced dexterity and visualization.
Purpose of the Study:
- To assess the feasibility of simple to complex endoscopic robotic mitral valve repair.
- To evaluate the efficacy of a lateral, ports-only approach.
- To demonstrate consistent and safe outcomes.
Main Methods:
- Retrospective data collection from 201 patients.
- Lateral, ports-only endoscopic robotic mitral valve repair.
- Aortic occlusion via endoaortic balloon or transthoracic clamp.
- Intraoperative assessment using transesophageal echocardiogram.
Main Results:
- Successful repair in 96.2% of 186 patients scheduled for repair.
- Conversion to sternotomy in 4.3% of patients.
- Post-repair regurgitation grade of 0-1 in 96.2% of patients.
- Low rates of mortality (1%) and reoperation (1-1.5%).
Conclusions:
- Lateral endoscopic robotic mitral valve repair is safe and feasible.
- The approach yields acceptable postoperative results.
- Further follow-up is needed to confirm long-term efficacy.
Related Concept Videos
Mitral Valve Prolapse II: Assessment and Management
Mitral Stenosis III: Medical Management
Mitral Regurgitation III: Medical Management
Mitral Stenosis I: Introduction
Mitral Valve Prolapse I: Introduction
