|
|
||||||||
J Thorac Cardiovasc Surg 2008;136:436-441
© 2008 The American Association for Thoracic Surgery
Surgery for Acquired Cardiovascular Disease |
a Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC
b Department of Biostatistics, East Carolina Heart Institute, East Carolina University, Greenville, NC
Received for publication January 10, 2008; revisions received March 9, 2008; accepted for publication March 27, 2008. * Address for reprints: W. Randolph Chitwood, Jr, MD, Department of Cardiovascular Sciences, East Carolina University, 600 Moye Blvd, Greenville, NC 27858. (Email: chitwoodw{at}ecu.edu).
Objectives: Mitral valve repair is the standard therapy for patients with degenerative (myxomatous) disease and severe mitral regurgitation. Robotic mitral valve repair provides the least-invasive surgical approach. We report the largest single-center robotic mitral valve repair experience.
Methods: Between May 2000 and November 2006, 300 patients underwent a robotic mitral valve repair (daVinci Surgical System; Intuitive Surgical, Inc, Sunnyvale, Calif). All operations were done with 3- to 4-cm right intercostal access, transthoracic aortic occlusion, and peripheral cardiopulmonary bypass. Repairs included 1 or a combination of trapezoidal/triangular leaflet resections, sliding plasties, chordal transfers/replacements, edge-to-edge approximations, and ring annuloplasties. Echocardiographic and survival follow-up were 93% and 100% complete, respectively.
Results: There were 2 (0.7%) 30-day mortalities and 6 (2.0%) late mortalities. No sternotomy conversions or mitral valve replacements were required. Immediate postrepair echocardiograms showed the following degrees of mitral regurgitation: none/trivial, 294 (98%); mild, 3 (1.0%); moderate, 3 (1.0%); and severe, 0 (0.0%). Complications included 2 (0.7%) strokes, 2 transient ischemic attacks, 3 (1.0%) myocardial infarctions, and 7 (2.3%) reoperations for bleeding. The mean hospital stay was 5.2 ± 4.2 (standard deviation) days. Sixteen (5.3%) patients required a reoperation. Mean postoperative echocardiographic follow-up at 815 ± 459 (standard deviation) days demonstrated the following degrees of mitral regurgitation: none/trivial, 192 (68.8%); mild, 66 (23.6%); moderate, 15 (5.4%); and severe, 6 (2.2%). Five-year Kaplan–Meier survival was 96.6% ± 1.5%, with 93.8% ± 1.6% freedom from reoperation.
Conclusions: Robotic mitral valve repair is safe and is associated with good midterm durability. Further long-term follow-up is necessary.
This article has been cited by other articles:
![]() |
T. Mihaljevic, A. M. Gillinov, C. Jarrett, L. Seto, R. Savage, and P. DeVilliers Endoscopic robotically-assisted mitral valve repair MMCTS, September 14, 2009; 2009(0914): 3608. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Modi, E. Rodriguez, and W. R. Chitwood Jr. Robot-assisted cardiac surgery Interactive CardioVascular and Thoracic Surgery, September 1, 2009; 9(3): 500 - 505. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. H. Adams, A. C. Anyanwu, J. Chikwe, and F. Filsoufi The Year in Cardiovascular Surgery J. Am. Coll. Cardiol., June 23, 2009; 53(25): 2389 - 2403. [Full Text] [PDF] |
||||
![]() |
A. Vahanian, B. Iung, L. Piérard, R. Dion, and J. Pepper CHAPTER 21 Valvular Heart Disease ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |