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Short- and Mid-Term Outcomes of Robotic Mitral Valve Repair for Degenerative Mitral Regurgitation in Octogenarians

Yojiro Machii1, Takashi Kakuta1, Naonori Kawamoto1

  • 1Department of Cardiac Surgery, National Cerebral and Cardiovascular Research Center Osaka Japan.

Circulation Reports
|June 11, 2026
PubMed
Abstract

Insights

Robotic mitral valve repair (r-MVr) is safe and feasible for octogenarians. This minimally invasive approach shows acceptable short- and mid-term outcomes in patients aged 80 and older.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Procedures
  • Geriatric Cardiology

Background:

  • Robotic mitral valve repair (r-MVr) offers potential benefits but its safety in octogenarians (≥80 years) is not well-established.
  • Degenerative mitral regurgitation is a common condition requiring intervention in the elderly population.

Purpose of the Study:

  • To evaluate the safety and feasibility of r-MVr in patients aged 80 years and older.
  • To compare short- and mid-term outcomes of r-MVr versus conventional MVr (c-MVr) in this specific patient group.

Main Methods:

  • Single-center retrospective cohort study of 53 patients (≥80 years) with degenerative mitral regurgitation.
  • Comparison between 31 patients undergoing r-MVr (da Vinci Xi system) and 22 patients undergoing c-MVr.
  • Primary outcomes included 30-day mortality, major complications, and length of stay; secondary outcomes included echocardiographic findings and mid-term survival.

Main Results:

  • One 30-day death occurred in the r-MVr group (3.2%) due to intestinal ischemia; no deaths occurred in the c-MVr group.
  • r-MVr was associated with a shorter postoperative hospital stay (12 vs. 13 days; P=0.04).
  • Lower transmitral pressure gradient post-procedure in r-MVr group (2.1 vs. 3.0 mmHg; P=0.02) and no significant differences in 5-year survival or freedom from recurrent mitral regurgitation.

Conclusions:

  • Robotic mitral valve repair (r-MVr) is a safe and feasible minimally invasive option for octogenarians.
  • The procedure demonstrates acceptable short- and mid-term outcomes in patients aged 80 and older.
  • r-MVr may be a viable alternative to conventional repair in this elderly demographic.
Keywords:
Degenerative mitral regurgitationElderlyMinimally invasive cardiac surgeryOctogenariansRobotic mitral valve repair

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