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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
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Long-term mortality following robotic mitral valve repair
Maxwell C Braasch1, Mehran Rahimi1, Ahmed Hanafy1
1Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, Mo.
JTCVS Structural and Endovascular
|April 9, 2026
Summary
Robotic mitral valve repair (MVr) shows similar long-term survival to conventional MVr for degenerative mitral regurgitation (DMR). This approach also resulted in shorter hospital stays and fewer complications, supporting its use in select patients.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Comparative Effectiveness Research
Background:
- Degenerative mitral regurgitation (DMR) is a common valvular heart disease.
- Surgical mitral valve repair (MVr) is the standard treatment for symptomatic DMR.
- Advancements in robotic surgery offer potential benefits over conventional approaches.
Purpose of the Study:
- To compare long-term mortality between robotic and conventional mitral valve repair (MVr) for degenerative mitral regurgitation (DMR).
- To assess secondary outcomes including hospital length of stay and complication rates.
Main Methods:
- Retrospective analysis of Medicare data (2012-2024) for patients undergoing surgical MVr for DMR.
- Exclusion of patients with prior cardiac surgery.
- 1:2 propensity score matching for robotic MVr (n=1502) and conventional MVr (n=12,182) groups to compare 5-year mortality.
Main Results:
- Robotic MVr patients were younger with lower comorbidity burden.
- Unadjusted 5-year mortality was lower in the robotic group (8.3% vs 15%).
- Risk-adjusted 5-year mortality was similar (8.8% vs 9.9%). Robotic MVr had shorter hospital stays and lower rates of renal failure and permanent pacemaker implantation.
Conclusions:
- Robotic MVr provides comparable long-term survival to conventional MVr for DMR in Medicare patients.
- The findings support the adoption of robotic MVr for appropriately selected patients and experienced surgical teams.
- Robotic approach demonstrates advantages in reduced length of stay and specific complication rates.
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