Comparison of clinical outcomes between robotic and thoracoscopic mitral valve repair

Abstract

Background: To compare the clinical outcomes and hospital cost of robotic versus thoracoscopic approaches to mitral valve plasty (MVP). Methods:We retrospectively analyzed patients who received minimal invasive MVP between 2007 January and 2020 January at our department. The basic characteristics, echocardiography, surgical data, postoperative adverse events and hospital cost of the patients were collected. The primary outcomes of this study were direct hospital cost and 30-day outcomes, including the operative time, complications, and length of hospital stay.Results: A total of 234 patients received minimally invasive MVP by using robotic (n=121) and thoracoscopic (n=113) technique respectively. The overall 30-day mortality rate was 0.9% (n=2), with no significant difference between two groups. The cardiopulmonary bypass time and aorta clamping time in thoracoscopic group were longer than that in robotic group (153.2±25.6 vs. 123.8±34.9 min and 111.8±23.0 vs. 84.9±24.3 min, P<0.001). The intraoperative blood transfusion rate (52.2% vs. 64.5%) and ICU time (2.8±2.3 vs. 3.6±2.7 days, all P<0.05) of the thoracoscopic group were lower than those in the robotic group. The adjusted hospital and operating room cost of the thoracoscopic group were significant lower

Comparison of clinical outcomes for total robotic versus total thoracoscopic mitral repair

“…We compared the short-term and midterm benefits of total robotic MVP and total thoracoscopic MVP with a retrospective study and concluded that both robotic and thoracoscopic MVP is safe and reliable. 3 In contrast to the findings of the study by Barac et al, the robotic technique had a shorter operative time in our study, while the thoracoscopic procedure was more advantageous in terms of ICU time, transfusion rates, hospital costs, and satisfactory clinical benefits were achieved in both groups at subsequent follow-up.…”

Robotic vs. minimally invasive mitral valve repair: A 5‐year comparison of surgical outcomes

“…Despite the thorough comparisons between MVr via minimally invasive techniques and via sternotomy, data on direct comparison of perioperative complications between robotic MVr and nonrobotic MVr are sparse. To date, only two studies directly compared robotic MVr to nonrobotic MVr 13,14 . Wei et al reported that robotic MVr had a shorter CPB time and aorta clamping time, but had more blood transfusions (63% vs. 52%), longer postoperative ventilation time (15 vs. 11 h) and longer ICU stay, while Barac et al reported a longer CPB time and aorta clamping time associated with robotic MVr.…”

“…To date, only two retrospective studies compared the operative outcomes of the two techniques. 13,14 We hypothesized that the freedom from reoperation and from recurrent MR is similar after robotic and nonrobotic MVr, as is the long-term survival. In this retrospective cohort study, we sought to analyze the durability of mitral valve repair as evaluated by freedom form reoperations and from MR recurrence of both minimally invasive techniques in patients undergoing mitral valve repair surgery at Mayo Clinic.…”

“…Data on the direct comparison of robotic to nonrobotic minimally invasive MVr are sparse. To date, only two retrospective studies compared the operative outcomes of the two techniques 13,14 . We hypothesized that the freedom from reoperation and from recurrent MR is similar after robotic and nonrobotic MVr, as is the long‐term survival.…”

“…Despite the thorough comparisons between MVr via minimally invasive techniques and via sternotomy, data on direct comparison of perioperative complications between robotic MVr and nonrobotic MVr are sparse. To date, only two studies directly compared robotic MVr to nonrobotic MVr 13,14. Wei et al…”