Early results of robotically assisted mitral valve repair in a single institution: report of the first 100 cases
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ORIGINAL ARTICLE
Early results of robotically assisted mitral valve repair in a single institution: report of the first 100 cases Takashi Kakuta1 · Satsuki Fukushima1 · Yusuke Shimahara1 · Shin Yajima1 · Naoki Tadokoro1 · Kimito Minami2 · Junjiro Kobayashi1 · Tomoyuki Fujita1 Received: 20 November 2019 / Accepted: 6 February 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Objective Robotically assisted mitral valve repair was approved for use in Japan in April 2018. The study objective was to assess the safety and clinical outcomes of robotic mitral valve surgery in the first 100 cases performed in our center. Methods We reviewed the first 100 patients who underwent robotic primary mitral valve repair, including concomitant procedures, from April 2018 to August 2019. The cause of mitral valve disease was degenerative (n = 94), endocarditis (n = 2), functional (n = 2), and other (n = 2). Results There was no in-hospital or 30-day mortality. Mitral valve repair was completed in all patients. Only one patient required conversion to full sternotomy due to left ventricular apex bleeding. In echocardiography performed before hospital discharge, the mitral regurgitation was graded as none or trivial in 94 patients (94%) and mild in 4 (4%). Only two patients required surgical re-intervention due to postoperative hemolysis with moderate mitral regurgitation. For patients who underwent the mitral valve procedure alone, the median times of the total operation, cardiopulmonary bypass, aortic clamping, and console usage were 185, 112, 71, and 60 min, respectively. The learning curve showed that the operation time decreased slightly during the first ten cases and then plateaued at a mean of approximately 180 min. Conclusions Robotically assisted mitral valve repair was feasible, safe, and therapeutically effective in the first 100 cases, with a minimal learning curve. The robotically assisted approach provides a high-quality surgical view and tremorless suture/ cut handling, which will contribute to further development of minimally invasive mitral valve surgery. Keywords Robotic surgery · Minimum invasive cardiac surgery · Mitral valve repair
Introduction Robotically assisted open heart surgery is under development towards becoming the least invasive method of cardiac surgery. In particular, robotically assisted mitral valve repair performed using a contemporary surgical assist system, such as the da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, California, USA), has already been shown to be feasible, safe, and effective, with less postoperative discomfort and blood product use compared with mitral valve repair * Tomoyuki Fujita [email protected] 1
Department of Cardiac Surgery, National Cerebral and Cardiovascular Research Center, 6‑1 Kishibe‑Shinmachi, Suita, Osaka 564‑8565, Japan
Department of Surgical Intensive Care, National Cerebral and Cardiovascular Research Center, Suita, Osaka, Japan
2
performed via the median sternotomy or mini-thoracotomy approach [1–8]. Robotically
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