Compare with Initial Results of Robot Assisted Mitral Valve Plasty and Concomitant Cases : Report of First 150 Cases
Daiki Yoshiyama, Yoshitsugu Nakamura, Yuto Yasumoto, Shuhei Nishijima, Miho Kuroda, Taisuke Nakayama, Ryo Tsuruta, Yujiro Ito
Chiba-Nishi General Hospital, 107-1 Kanagasaku-cyo Matsuyoshi Chiba-ken 270-2251, Japan
ObjectiveMinimally Invasive Cardiac Surgery Mitral valve repair (MICS MVP) was performed 227 cases in our center from December 2013. After that experience, we introduced Robotically assisted mitral valve repair (RMVR) in June 2018. The study objective was to assess the safety and clinical outcomes of RMVR in the first 150 cases performed in our center. MethodsWe reviewed the first 150 patients who underwent RMVR, including concomitant procedures (tricuspid valve annuloplasty (TAP), maze, left arterial appendage closure, patent foramen ovale), from June 2018 to December 2020. Patients were divided into RMVR 100 patients [ Isolated group (n = 100)] and concomitant 50 patients who were procedure TAP or maze [ Concomitant group (n = 50)] . ResultsThe mean age was 66 ± 13 years, 74 patients were female, BSA was 1.55 ± 0.18, euroSCORE2 was 2.2±2.1, New York Heart Association class (NYHA) 3 or 4 was 49 patients(32.7%), mean ejection fraction was 68.7% ± 8.4%. We were found in the “Isolated group” that shorter operative time (231±50 vs 260±60 min, P=0.001) and cardiopulmonary bypass time (159±43 vs 178±42 min, P=0.007); no significant difference for aortic clamping time (128±38 vs 138±39 min, P=0.066). There were no significant difference for in-hospital or 30-day mortality, mean intubation time (9.1±13.2 vs 10.6±9.6 hours, P=0.25), ICU stay (2.7±2.1 vs 2.8±1.9 days, P=0.36) and hospital stay (11.1±9.3 vs 13.3±11.4 days, P=0.12). The complications did not have the significant difference between both groups. Complications included one reexploration for bleeding (0.7%) , 1 strokes (0.7%), 1 subarachnoid hemorrhage (0.7%), 3 postoperative hemolysis (2.0%). Only 1 patients required surgical re-intervention due to moderate mitral regurgitation (0.7%). In echocardiography performed before hospital discharge, the mitral regurgitation was graded as none or trivial in 145 patients (96.7%). ConclusionsThe clinical outcomes of RMVR was satisfactory in the initial 150 cases even though concomitant cases required significantly longer operation and cardiopulmonary bypass time. However, concomitant group was not associated with a risk-adjusted increase in complications.