Robotic versus port-access mitral repair: A propensity score analysis

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Surgical Technology

Background:

• Port-access (PORT) and robotic (ROBO) mitral repair are established minimally invasive techniques.
• Comparative data on patient selection and long-term outcomes between ROBO and PORT mitral repair are limited.

Purpose of the Study:

• To compare patient characteristics and clinical outcomes between robotic-assisted and port-access mitral repair.
• To evaluate the 5-year durability, survival, and morbidity associated with each surgical approach.

Main Methods:

• Retrospective analysis of 129 robotic (ROBO) and 628 port-access (PORT) mitral repairs.
• Patients were matched using propensity score analysis to account for baseline characteristic differences.
• Comparison of operative times, length of stay, postoperative morbidity, 5-year survival, and repair durability.

Main Results:

• ROBO patients had significantly longer pump and clamp times compared to PORT patients.
• No significant differences were observed in length of stay, postoperative morbidity, or 5-year survival.
• Five-year incidence of mitral reoperation, severe mitral regurgitation, or ≥2+ mitral regurgitation was similar between ROBO and PORT approaches for degenerative valve disease.

Conclusions:

• Robotic mitral repair is associated with increased operative times (pump and clamp) compared to port-access repair.
• Both surgical approaches yield comparable perioperative morbidity, 5-year survival rates, and 5-year repair durability.
• Surgical approach does not appear to be a predictor of recurrent moderate mitral regurgitation.