Robotic Mitral Valve Repair for Anterior Leaflet and Bileaflet Prolapse

Evelio Rodriguez, L. Wiley Nifong, Michael W.A. Chu, William Wood, Paul W. Vos, W. Randolph Chitwood

    Research output: Contribution to journalArticle

    44 Citations (Scopus)

    Abstract

    Background: Centers have expanded indications for robotic mitral valve repairs to include complex pathologic features. We studied our results after robotic mitral valve repair for anterior leaflet or bileaflet prolapse. Methods: Data were collected contemporaneously on 289 patients operated on from May 2000 to September 2006. Every patient underwent preoperative transesophageal echocardiography. Follow-up consisted of serial echocardiograms, clinic visits, and phone conversations with patients and their physicians. Results: A total of 66 patients (anterior leaflet, n = 14; and bileaflet, n = 52) were identified. Mean age was 52.6 ± 7.1 years, and 57 (86%) patients had New York Heart Association functional class II or III symptoms. Cardiopulmonary bypass and cross-clamp times were 171 ± 52 and 132 ± 39 minutes, respectively. The 30-day and late mortality rates were 3% (n = 2) for each time point. There were no device-related or perfusion-related complications or sternotomy conversions. Complications included 2 strokes (3%), 2 bleeding reexplorations (3%), and 10 pleural effusions requiring intervention (15%). The length of hospital stay for surviving patients was 5 ± 3 days, and time to extubation averaged 9.5 ± 13 hours. A total of 6 (9%) patients required valve reoperation. Mean follow-up was 795 ± 495 days, and echocardiographic mitral regurgitation (n = 60) was none or trace (n = 35, 58.3%), mild (n = 19, 31.6%), moderate (n = 2, 3.3%), and severe (n = 4, 6.7%). Conclusions: Robotic mitral valve repair for anterior leaflet and bileaflet prolapse is feasible and safe. Outcomes and degree of late mitral regurgitation are similar to series using conventional techniques. Long-term follow-up is required to formally address the efficacy of robotic repair techniques.

    Original languageEnglish (US)
    Pages (from-to)438-444
    Number of pages7
    JournalAnnals of Thoracic Surgery
    Volume85
    Issue number2
    DOIs
    StatePublished - Feb 1 2008

    Fingerprint

    Prolapse
    Robotics
    Mitral Valve
    Mitral Valve Insufficiency
    Length of Stay
    Sternotomy
    Transesophageal Echocardiography
    Pleural Effusion
    Ambulatory Care
    Cardiopulmonary Bypass
    Reoperation
    Perfusion
    Stroke
    Hemorrhage
    Physicians
    Equipment and Supplies
    Mortality

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Pulmonary and Respiratory Medicine
    • Cardiology and Cardiovascular Medicine

    Cite this

    Rodriguez, E., Nifong, L. W., Chu, M. W. A., Wood, W., Vos, P. W., & Chitwood, W. R. (2008). Robotic Mitral Valve Repair for Anterior Leaflet and Bileaflet Prolapse. Annals of Thoracic Surgery, 85(2), 438-444. https://doi.org/10.1016/j.athoracsur.2007.04.122

    Robotic Mitral Valve Repair for Anterior Leaflet and Bileaflet Prolapse. / Rodriguez, Evelio; Nifong, L. Wiley; Chu, Michael W.A.; Wood, William; Vos, Paul W.; Chitwood, W. Randolph.

    In: Annals of Thoracic Surgery, Vol. 85, No. 2, 01.02.2008, p. 438-444.

    Research output: Contribution to journalArticle

    Rodriguez, E, Nifong, LW, Chu, MWA, Wood, W, Vos, PW & Chitwood, WR 2008, 'Robotic Mitral Valve Repair for Anterior Leaflet and Bileaflet Prolapse', Annals of Thoracic Surgery, vol. 85, no. 2, pp. 438-444. https://doi.org/10.1016/j.athoracsur.2007.04.122
    Rodriguez, Evelio ; Nifong, L. Wiley ; Chu, Michael W.A. ; Wood, William ; Vos, Paul W. ; Chitwood, W. Randolph. / Robotic Mitral Valve Repair for Anterior Leaflet and Bileaflet Prolapse. In: Annals of Thoracic Surgery. 2008 ; Vol. 85, No. 2. pp. 438-444.
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    abstract = "Background: Centers have expanded indications for robotic mitral valve repairs to include complex pathologic features. We studied our results after robotic mitral valve repair for anterior leaflet or bileaflet prolapse. Methods: Data were collected contemporaneously on 289 patients operated on from May 2000 to September 2006. Every patient underwent preoperative transesophageal echocardiography. Follow-up consisted of serial echocardiograms, clinic visits, and phone conversations with patients and their physicians. Results: A total of 66 patients (anterior leaflet, n = 14; and bileaflet, n = 52) were identified. Mean age was 52.6 ± 7.1 years, and 57 (86{\%}) patients had New York Heart Association functional class II or III symptoms. Cardiopulmonary bypass and cross-clamp times were 171 ± 52 and 132 ± 39 minutes, respectively. The 30-day and late mortality rates were 3{\%} (n = 2) for each time point. There were no device-related or perfusion-related complications or sternotomy conversions. Complications included 2 strokes (3{\%}), 2 bleeding reexplorations (3{\%}), and 10 pleural effusions requiring intervention (15{\%}). The length of hospital stay for surviving patients was 5 ± 3 days, and time to extubation averaged 9.5 ± 13 hours. A total of 6 (9{\%}) patients required valve reoperation. Mean follow-up was 795 ± 495 days, and echocardiographic mitral regurgitation (n = 60) was none or trace (n = 35, 58.3{\%}), mild (n = 19, 31.6{\%}), moderate (n = 2, 3.3{\%}), and severe (n = 4, 6.7{\%}). Conclusions: Robotic mitral valve repair for anterior leaflet and bileaflet prolapse is feasible and safe. Outcomes and degree of late mitral regurgitation are similar to series using conventional techniques. Long-term follow-up is required to formally address the efficacy of robotic repair techniques.",
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