Feasibility of Robotically Assisted Concomitant Procedures During Mitral Valve Operations
Ahmet Ümit Güllü, Şahin Şenay, Muharrem Koçyiğit, Murat Okten, Mert Dumantepe, Hasan Karabulut, Cem Alhan.
Acibadem Mehmet Ali Aydınlar University, School of Medicine, Istanbul, Turkey.
BACKGROUND: Concomitant interventions may be required during robot assisted mitral valve operations however the prolonged cross clamp times is an important issue for postoperative outcomes especially in the early period of robotic programme. This concern is gradually diminishing with the advances of surgical experience. Here in this report, we present our clinical experience with the robot assisted surgery of the concomitant procedures during mitral valve interventions. METHODS: From March 2010 to February 2018, a total of 238 patients underwent robotic cardiac procedures in our center. Additional procedures (n=76) beside mitral valve intervention was performed in 34 of these patients (14.2%) with robotic assistance. RESULTS: Concomitant procedures were cryoablation (n=28), tricuspid valve repair (n=7), tricuspid valve replacement (n=2), left atrial appendage ligation (n=30), ASD and PFO closure (n=8) and left atrial thrombectomy (n=1). Normal sinus rhythm was restored in 85% (24/28) of patients after cryoablation in 1 year of follow up. There was one mortality at early postoperative period (2.9%) and the reason was hemorrhage related to posterior left ventricular wall rupture. Any kind of blood product was not used in 82.4% of patients. Renal failure requiring dialysis was not needed in any patient. CONCLUSIONS: Robotic assisted concomitant procedures beside mitral valve operations can be performed with low complication rates in centers with experience of robotic surgery.
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