PMID- 36483615
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221210
IS  - 2225-319X (Print)
IS  - 2304-1021 (Electronic)
IS  - 2225-319X (Linking)
VI  - 11
IP  - 6
DP  - 2022 Nov
TI  - Robotic mitral valve repair-the Bruxelles experience.
PG  - 589-595
LID - 10.21037/acs-2022-rmvs-20 [doi]
AB  - BACKGROUND: Although the use of the surgical robot facilitates less invasive 
      mitral valve surgery, both real and perceived limitations have slowed the 
      application of this technology. Aim of the present investigation was to report 
      the early and long-term results of robotic mitral valve repair in a single 
      institution over a 10-year period. METHODS: Between March 2012 and May 2022, a 
      total of 278 consecutive patients underwent robotically assisted mitral valve 
      repair at the Cliniques Universitaires Saint-Luc (Brussels, Belgium). Indications 
      have evolved over time allowing the treatment of complex mitral valve lesions. 
      Clinical and echocardiographic follow-up were 97.8% and 86.1% complete, 
      respectively. RESULTS: Mean age of the study population was 57.8+/-11.9 years and 
      221/278 (79.5%) patients were male. Despite being asymptomatic or mildly 
      symptomatic [New York Heart Association (NYHA) class I-II], most of the patients 
      presented with severe mitral regurgitation (MR). Degenerative mitral valve 
      disease was the most common cause of MR. All patients underwent successful mitral 
      valve repair using different techniques, and 25/278 (9.0%) had one or more 
      concomitant procedures associated. The mean cardio-pulmonary bypass and aortic 
      cross clamp times were 153+/-37 and 106+/-25 minutes, respectively. There was no 
      operative or in-hospital mortality. Overall survival rate was 97.8%+/-3.2%, 
      95.8%+/-3.2% and 93.7%+/-3.0% at 3, 7 and 10 years. One early (0.4%) reoperation with 
      re-repair was recorded for ring disruption, while late mitral valve re-repair was 
      necessary in 4/279 (1.4%) patients for recurrent severe MR in three of them and 
      mitral endocarditis in one. The overall freedom from mitral valve reoperation was 
      98.1%+/-1.0% at 3, 7 and 10 years. Overall freedom from MR (grade 2+ or more) was 
      91.7%+/-3.2%, 77.8%+/-4.8% and 67.1%+/-9.2% at 3, 7 and 10 years, respectively. 
      CONCLUSIONS: Robotic mitral valve repair is safe and is associated with excellent 
      clinical and echocardiographic results. The use of robotic technologies allows, 
      after an appropriate learning curve, to reproduce all conventional techniques to 
      treat MR, regardless of the complexity of the valve lesion.
CI  - 2022 Annals of Cardiothoracic Surgery. All rights reserved.
FAU - Aphram, Gaby
AU  - Aphram G
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
FAU - Melina, Giovanni
AU  - Melina G
AD  - Cardiac Surgery Unit, Ospedale Sant'Andrea, "Sapienza" University of Rome, Rome, 
      Italy.
FAU - Noirhomme, Philippe
AU  - Noirhomme P
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
FAU - De Kerchove, Laurent
AU  - De Kerchove L
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
FAU - Mastrobuoni, Stefano
AU  - Mastrobuoni S
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
FAU - Klepper, Maureen
AU  - Klepper M
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
FAU - El Khoury, Gebrine
AU  - El Khoury G
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
FAU - Navarra, Emiliano
AU  - Navarra E
AD  - Department of Cardiovascular and Thoracic Surgery, Saint-Luc Hospital, Catholic 
      University of Louvain, Brussels, Belgium.
AD  - Cardiac Surgery Unit, Ospedale Sant'Andrea, "Sapienza" University of Rome, Rome, 
      Italy.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Cardiothorac Surg
JT  - Annals of cardiothoracic surgery
JID - 101605877
PMC - PMC9723534
OTO - NOTNLM
OT  - Robotic mitral repair
OT  - mitral regurgitation robotic repair
OT  - robot-assisted mitral repair
OT  - robotic mitral surgery
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2022/12/10 06:00
MHDA- 2022/12/10 06:01
PMCR- 2022/11/01
CRDT- 2022/12/09 04:07
PHST- 2022/06/26 00:00 [received]
PHST- 2022/10/05 00:00 [accepted]
PHST- 2022/12/09 04:07 [entrez]
PHST- 2022/12/10 06:00 [pubmed]
PHST- 2022/12/10 06:01 [medline]
PHST- 2022/11/01 00:00 [pmc-release]
AID - acs-11-06-589 [pii]
AID - 10.21037/acs-2022-rmvs-20 [doi]
PST - ppublish
SO  - Ann Cardiothorac Surg. 2022 Nov;11(6):589-595. doi: 10.21037/acs-2022-rmvs-20.