Redo Robotic-Assisted Mitral Valve Repair
Mark Lutz, BA, Courtney Maxey-Jones, M.D., Zhandong Zhou, M.D., Ahmad Nazem, M.D., G Randall Green, M.D., J.D., M.B.A, Anton Cherney, M.D, Karikehalli Dilip, M.D., Charles Lutz, M.D..
St Joseph's Hospital, Syracuse, NY, USA.
BACKGROUND: Redo robotic-assisted mitral valve repair remains relatively uncommon METHODS: 54 year old male in 2004 underwent a robotic-assisted mitral valve repair consisting of a triangular P2 resection, leaflet repair, and posterior annuloplasty band insertion secured with nitinol U-clips. He remained stable but experienced a respiratory infection earlier this year associated with shortness of breath on exertion. Cardiology follow-up revealed a new systolic heart murmur and episodes of intermittent atrial fibrillation. Subsequent TEE revealed evidence of a likely posterior leaflet perforation. We felt this was repairable with a robotic assisted approach.
RESULTS: The patient underwent successful robotic-assisted mitral valve repair consisting of primary repair of the posterior leaflet perforation, P1/P2 cleft repair, and posterior annuloplasty band placement with a cryomaze procedure and endocardial ligation of left atrial appendage. Intraoperative transesophageal echocardiography revealed no mitral regurgitation.
CONCLUSIONS: Redo robotic-assisted repair is feasible in select patients with favorable pathology.
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