Robotic vs Open Surgical Repair of Partial Anomalous Pulmonary Venous Drainage in Adults

Robotic cardiac surgery has emerged as an alternative to conventional sternotomy for adult congenital heart defect repairs. However, comparative data between robotic and open surgical approaches for right-sided partial anomalous pulmonary venous drainage repair in adults are lacking. This study aimed to compare perioperative outcomes between these surgical modalities.

This retrospective single-center cohort study included 129 consecutive adult patients who underwent surgical repair for partial anomalous pulmonary venous drainage between April 2012 and June 2025. Patients were divided into robotic (n = 62) and open surgery (n = 67) groups. The primary end point was hospital stay. Secondary end points included blood product use, postoperative complications, and 30-day mortality. Multivariable regression analyses were performed to identify independent predictors of outcomes.

Hospital length of stay was significantly shorter in the robotic group (4.7 ± 1.8 vs 6.0 ± 3.7 days; P = .002). After multivariable adjustment, robotic surgery remained independently associated with reduced hospital stay (β, -0.121; P = .029). Blood product use was significantly lower in the robotic group (1.3 ± 1.6 vs 2.0 ± 2.0 units; P = .04). In multivariable negative binomial regression, robotic surgery was associated with a 62.5% reduction in transfusion requirements (incidence rate ratio, 0.375; P < .001). Despite longer cardiopulmonary bypass durations in the robotic group (138.6 ± 37.2 vs 74.1 ± 33.1 minutes; P < .001), complication rates were comparable (22.6% vs 26.9%; P = .72). Thirty-day mortality was similar between groups (1.6% vs 1.5%; P = .99).

Robotic surgery for right-sided partial anomalous pulmonary venous drainage repair in adults is associated with shorter hospital length of stay and reduced blood product use compared with conventional open surgery, with equivalent safety outcomes.