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Surgical and Anesthesia-Related Concerns forRobot-Assisted Pediatric Cardiac Surgery.

John A Kucera1, Fintan Hughes2, Seth E M Wolf1

  • 1Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC.

Journal of Cardiothoracic and Vascular Anesthesia
|December 6, 2025
PubMed
Summary

Robot-assisted cardiac surgery is safe and effective for selected pediatric patients, even those weighing as little as 24 kg. Successful outcomes depend on experienced teams and careful anesthetic management for this specialized group.

Keywords:
pediatric cardiac surgeryrobot-assisted cardiac surgery

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Area of Science:

  • Pediatric Cardiac Surgery
  • Minimally Invasive Cardiac Surgery
  • Robotic Surgery

Background:

  • Robot-assisted cardiac surgery (RACS) offers potential benefits in pediatric cardiac procedures.
  • Implementing RACS requires careful consideration of patient selection and surgical technique.

Purpose of the Study:

  • To describe a cohort of pediatric patients undergoing RACS.
  • To discuss anesthetic and perioperative considerations for optimizing outcomes in pediatric RACS.

Main Methods:

  • Retrospective observational cohort study at an academic tertiary care center.
  • Analysis of nine pediatric patients undergoing RACS between 2022 and 2024.
  • Review of indications including atrial septal defect and mitral valve regurgitation.

Main Results:

  • Mean age was 13.1 years; mean weight was 48.5 kg.
  • Average operative time was 388.2 minutes, with a cardiopulmonary bypass time of 192.1 minutes.
  • Low complication rate, with no mortality; most patients extubated in the OR.

Conclusions:

  • RACS is well-tolerated in appropriately selected pediatric patients.
  • Institutional experience and multidisciplinary collaboration are key to successful RACS.
  • Anesthesiologists must understand unique considerations for pediatric RACS.