Robotic mitral valve repair: 7-year surgical experience and mid-term follow-up results

The feasibility and safety of robotic mitral valve repair has been proven in several studies but the mid-term to long-term outcomes are unclear. We aim to summarize our surgical experience with robotic mitral valve repair and demonstrate the follow-up results out to 7 years.

From 2007 to 2014, 110 consecutive patients underwent robotic mitral valve repair with da Vinci Surgical System (Intuitive Surgical, USA) in our center. The operative data were collected, and patients were echocardiographically followed regularly up to 7 years.

The patients' average age was 45±13 (14 to 70) years with male to female ratio of 2.3:1. Mitral regurgitation (95.5%) or stenosis (4.5%) was diagnosed. The triangular or quadrangular resection was the most performed type of repair (63.3%). Nitinol U-clips (58.1%), running suture (31.1%), and Cor-Knot™ suture device (LSI Solutions, Victor, NY) (10.8%) were used to secure the annuloplasty ring. All cases were performed by the same surgeon. One case of conversion to sternotomy was noted. The mean CPB time was 121±34.3 (range, 70 to 152) minutes, and the mean cross-clamp time was 82.6±25.3 (range, 47 to 122) minutes. After surgery, one death (0.91%) and two cases of transient neurocognitive defect (1.82%) occurred. Three cases of early failure of repair that required reoperation (2.73%) were noticed. All patients were successfully followed for a median of 4.1 (range, 1 month to 7 years) years and 94.5% had freedom of re-operation.

Robotic mitral valve repair is a safe and effective procedure with excellent mid-term outcomes.