HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Antone J. Tatooles Mark S. Slaughter Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tatooles, A. J. Articles by Slaughter, M. S. Search for Related Content PubMed PubMed Citation Articles by Tatooles, A. J. Articles by Slaughter, M. S. Related Collections Valve disease

Ann Thorac Surg 2004;77:1978-1984
© 2004 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Minimally invasive mitral valve repair using the da Vinci robotic system

^a Division of Cardiac Surgery, Advocate Christ Medical Center, Oak Lawn, Illinois, USA

Accepted for publication November 25, 2003.

^* Address correspondence to Dr Slaughter, Cardiothoracic and Vascular Surgical Associates, SC, 4400 W 95th St, Suite 205, Oak Lawn, IL 60453, USA
e-mail: mscabg{at}aol.com

Presented at the Thirty-ninth Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2003.

BACKGROUND: Minimally invasive mitral valve repair with a shortened hospital stay and quick return to an active lifestyle is the ultimate goal for robotically assisted surgery. We evaluated our da Vinci robotically assisted mitral valve repair experience toward achieving this goal.

METHODS: All procedures were performed with peripheral cardiopulmonary bypass, transthoracic aortic cross-clamp, and antegrade cardioplegia. Two ports and a 4-cm intercostal incision in the right chest were used for access. All patients had a ring annuloplasty, and all but 1 had a posterior leaflet resection. The entire repair and all knot tying were performed robotically.

RESULTS: Between October 2001 and October 2002, 25 patients (18 men) underwent robotic mitral valve repair. The mean age was 56 years (range, 37 to 81 years). There were no incisional conversions, deaths, strokes, or reoperations for bleeding. Twenty-one (84%) of 25 patients were extubated in the operating room. Overall mean study times were as follows: procedure, 199.7 minutes (range, 140 to 287 minutes); cardiopulmonary bypass, 126.6 minutes (range, 89 to 186 minutes); and cross-clamp, 87.7 minutes (range, 58 to 143 minutes). Eight (32%) patients were discharged home in less than 24 hours, with an average length of stay of 2.7 days. Comparing the first 10 patients to the last 15 there was a significant reduction of times: total operating room time, 318.5 versus 275.1 minutes; cross-clamp, 97.6 versus 81.1 minutes; leaflet resection or repair, 26.2 versus 15.6 minutes; annuloplasty ring, 31.9 versus 24.8 minutes; and length of stay, from 4.2 days to 1.67 days. Five patients had postoperative atrial fibrillation. Two (8%) patients ultimately required mitral valve replacement for recurrent mitral insufficiency.

CONCLUSIONS: Mitral valve repair can be successfully performed with the da Vinci robotic system. Long-term follow-up is needed to determine the durability of the repair compared with a standard sternotomy approach.

This article has been cited by other articles:

				W. R. Chitwood Jr., E. Rodriguez, M. W.A. Chu, A. Hassan, T. B. Ferguson, P. W. Vos, and L. W. Nifong Robotic mitral valve repairs in 300 patients: a single-center experience. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 436 - 441. [Abstract] [Full Text] [PDF]

				T. K. Rosengart, T. Feldman, M. A. Borger, T. A. Vassiliades Jr, A. M. Gillinov, K. J. Hoercher, A. Vahanian, R. O. Bonow, and W. O'Neill Percutaneous and Minimally Invasive Valve Procedures: A Scientific Statement From the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group Circulation, April 1, 2008; 117(13): 1750 - 1767. [Abstract] [Full Text] [PDF]

				T. Folliguet, F. Vanhuyse, X. Constantino, M. Realli, and F. Laborde Mitral valve repair robotic versus sternotomy Eur. J. Cardiothorac. Surg., March 1, 2006; 29(3): 362 - 366. [Abstract] [Full Text] [PDF]

				C. L. Lake Simulation in Cardiology and Cardiothoracic and Vascular Surgery Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2005; 9(4): 325 - 333-1. [Abstract] [PDF]