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Initial Experience With Robotic Mitral Valve Replacement: Results From a Single Centre
Ersin Kadiroğulları1, Zihni Mert Duman2, Salih Güler1
1Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital, University of Health Sciences, Istanbul, Turkey.
Interdisciplinary Cardiovascular and Thoracic Surgery
|January 8, 2026
Summary
Robot-assisted mitral valve replacement shows a learning curve. Achieving surgical mastery and handling complex cases requires approximately 93 procedures for improved efficiency and outcomes.
Area of Science:
- Cardiac Surgery
- Minimally Invasive Techniques
- Robotic Surgery
Background:
- Robot-assisted mitral valve replacement (RAMVR) offers comparable safety and efficacy to conventional surgery.
- Our institution has over a decade of experience with the Da Vinci Surgical System for RAMVR.
Purpose of the Study:
- To evaluate the evolution of clinical outcomes over time in RAMVR.
- To assess the impact of the surgical learning curve on RAMVR procedures.
Main Methods:
- Analysis of 233 RAMVR patients (July 2013-January 2024).
- Procedures performed by four experienced robotic cardiac surgeons.
- Cumulative sum analysis of cardiopulmonary bypass time and Mitral Surgery Complexity Score to define learning curve phases.
Main Results:
- Identified three phases: learning (1-27 cases), proficiency (28-92 cases), and mastery (93+ cases).
- Cardiopulmonary bypass time and Mitral Surgery Complexity Score trends indicate evolving surgical efficiency.
- An increase in complexity scores after case 92 suggests a transition to more challenging cases.
Conclusions:
- RAMVR demonstrates a quantifiable learning curve impacting surgical efficiency and case complexity.
- Around 93 procedures are needed to reach operative stability for complex mitral valve replacements.
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