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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
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Transthoracic Aortic Clamp Technique for Port-Only Endoscopic Robotic Mitral Surgery
Douglas A Murphy1, Ryon L Arrington1, Amalia A Jonsson1
1Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Innovations (Philadelphia, Pa.)
|May 26, 2023
Summary
This study introduces a port-only endoscopic robotic mitral surgery technique using transthoracic aortic clamping, offering a safe alternative for specific patient anatomies and surgeon preferences.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robotic mitral surgery commonly uses right thoracotomy or port-only approaches with endoaortic balloon occlusion.
- Transthoracic aortic clamping is a traditional method for aortic occlusion during cardiac surgery.
Purpose of the Study:
- To present a novel technique for port-only endoscopic robotic mitral surgery utilizing transthoracic aortic clamping.
- To evaluate the safety and feasibility of this combined approach.
Main Methods:
- 133 patients underwent port-only endoscopic robotic mitral surgery with transthoracic clamp aortic occlusion.
- Antegrade cardioplegia was administered.
- Perfusion was achieved via femoral or axillary artery access.
- Specific clamp placement and aortic valve testing protocols were followed.
Main Results:
- Mitral repair was performed in 92.7% of patients, and valve replacement in 8.3%.
- Mean aortic occlusion time was 92 ± 21.4 minutes.
- No aortic injuries, mortality, strokes, or renal failure were reported.
Conclusions:
- This port-only endoscopic robotic approach with transthoracic clamping is a safe and effective alternative.
- It is particularly useful for patients with aortoiliac pathology or limited femoral access.
- It offers a transition option for teams accustomed to transthoracic clamping.
