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OBJECTIVE: In this study, we determined the safety and efficacy of robotic mitral valve replacement using robotic technology.
METHODS: From January 2007 through March 2011, over 500 patients underwent various kinds of robotic cardiac surgery in our department, in which 45 consecutive patients underwent robotically assisted mitral valve replacement. In 45 patients with isolated rheumatic mitral valve stenosis (14 males, 31 females), mean age was 46.7±19.8 (range 32 to 67 years) years. Preoperatively, all patients underwent a complete work-up, including coronary angiography and transthoracic echocardiography. 19 patients had concomitant atrial fibrillation. Surgical approach was through 4 right chest ports with femoral perfusion, aortic occlusion was performed with Chitwood crossclamp, and antegrade cardioplegia was administered directly via anterior chest. Via 3 port incisions in the right chest and 2.5 to 3.0 cm working port. Cor-Knot (Lsisolution, Victory-mendon, New York, US) was used to tie the knots in robotic mitral valve replacement, all the procedures were completed with the da Vinci S robot.
RESULTS: All patients had successful robotic surgery. 34 patients had mechanical valve, and 11 had tissue valve. The mean CPB time and aortic crossclamp time were 80.1±11.9 (60 to 168) min and 66.3±12.9 (45 to 133) min, respectively. There were no operative deaths, stroke, or other complications. There were no incisional conversions. After operation, all patients were followed up Echocardiographically.
CONCLUSIONS:
Robotically assisted mitral replacement can be performed safely in patients with isolated mitral valve stenosis, and surgical results are excellent.