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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

532
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

422
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
422
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

557
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
557
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

586
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
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Updated: Apr 29, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Value of robotically assisted surgery for mitral valve disease.

Tomislav Mihaljevic1, Marijan Koprivanac2, Marta Kelava2

  • 1Heart and Vascular Institute, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio2Heart and Vascular Institute, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Abu Dhabi, United Arab Emirates.

JAMA Surgery
|May 23, 2014
PubMed
Summary

Robotically assisted surgery for mitral valve repair offers faster recovery and lower postoperative costs, despite higher initial expenses. Its value becomes comparable to conventional methods in high-volume centers.

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Surgery
  • Health Economics

Background:

  • Robotically assisted surgery (RAS) for mitral valve disease presents a high-cost technology.
  • The clinical benefits of RAS must be weighed against its associated financial implications.

Purpose of the Study:

  • To determine the conditions under which the benefits of RAS mitigate its high technology costs for mitral valve repair.
  • To compare the cost-effectiveness of RAS versus traditional surgical approaches.

Main Methods:

  • A clinical cohort study compared RAS with sternotomy, partial sternotomy, and thoracotomy for degenerative mitral valve disease.
  • Propensity-matched groups (n=1290) were analyzed based on demographics, comorbidities, and echocardiographic data.
  • Costs included capital investment, maintenance, and direct hospital costs; benefits were assessed by recovery time and return to work.

Main Results:

  • RAS incurred higher procedural costs (20.7%-32.1%) compared to conventional methods.
  • These costs were offset by reduced postoperative expenses and significantly faster return to work (35 days for RAS vs. 42-56 days for others).
  • Net cost differences became comparable when annual surgical volume exceeded 55-100 procedures.

Conclusions:

  • RAS for mitral valve repair provides benefits of minimally invasive surgery, lower postoperative costs, and quicker return to work.
  • The value proposition of RAS is realized in high-volume centers where costs overlap with conventional approaches.
  • High-volume RAS centers can achieve cost-effectiveness comparable to traditional mitral valve surgery.