Comparison of postoperative outcomes between robotic mitral valve replacement and conventional mitral valve replacement

Sicim, Hüseyin; Kadan, Murat; Erol, Gökhan; Yıldırım, Vedat; Bolcal, Cengiz; Demirkılıç, Ufuk

doi:10.1111/jocs.15418

Cited by 11 publications

(15 citation statements)

References 24 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Advances in percutaneous techniques and the emerging competition since the 1990s have led surgeons to try to achieve these excellent results with less invasive methods. 4 Beyond the good cosmetic results, minimally invasive procedures are preferred because of the small size of the incision, less wound infection, less postoperative bleeding, and therefore less need for blood and blood products, and shorter intensive care and hospital stays. 5 Calafiore et al 6 However, it must be acknowledged that the difficulty of the surgical technique is known to be the main limitation for all previously described minimally invasive multivessel coronary grafting techniques.…”

Section: Discussionmentioning

confidence: 99%

Routine minimally invasive approach via left anterior mini‐thoracotomy in multivessel coronary revascularization

Çaynak¹,

Sicim

2022

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

Background: Minimally invasive heart surgery continues to spread rapidly around the world. Although coronary artery bypass surgery with median sternotomy continues to be performed intensively in many centers, the results of the new literature continue to contribute to proving the reliability of minimally invasive coronary surgery. In this study, we aimed to contribute to the routine feasibility of minimally invasive coronary bypass with left anterior mini-thoracotomy with our own case series.Methods: From July 2019 to August 2021 a total of 184 nonselected consecutive patients underwent minimally invasive on-pump multivessel coronary artery bypass grafting through the left anterior minithoracotomy in the fourth intercostal space. In the operation decision; regardless of low ejection fraction, morbid obesity, number of diseased vessels, or other comorbid factors, bypass operation was performed routinely via thoracotomy without selecting patients, except redo patients or porcelain aorta. The mean number of grafts was 3.3 ± 0.5. Left internal mammary artery was used in all patients. For other anastomoses; saphenous vein graft was used.Cardiopulmonary bypass (CPB), aortic cross-clamping, and blood cardioplegia were used in all patients. Postoperative results of all patients were analyzed retrospectively. Results:The total CPB time was 144.5 ± 27.3 min, and aortic cross-clamp time 82.1 ± 16.2 min. The mean intensive care stay was 1.2 ± 0.7 days and mean total hospital stay 5.1 ± 1.2 days. Total perioperative mortality was 0.54% (one patient). Myocardial infarction was not observed in any case in the postoperative period. The cause of mortality was delayed tamponade occurring on the fifth postoperative day.Nine patients underwent revision due to bleeding in the early postoperative period.There was no patient who underwent stroke or developed renal failure requiring hemodialysis in the postoperative period. One hundred and eighty-three patients (99.4%) were discharged with good recovery. Conclusion:Minimally invasive multivessel bypass surgery is a surgical method that has just started to become widespread. The fact that the technique is new and more challenging than conventional methods makes it difficult for surgeons to adopt it. In addition, one of the most important issues is that the surgical results should be satisfactory. Our study shows that safe, successful, and satisfactory results can be

show abstract

Section: Discussionmentioning

confidence: 99%

Routine minimally invasive approach via left anterior mini‐thoracotomy in multivessel coronary revascularization

Çaynak¹,

Sicim

2022

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Of the fourteen included studies, thirteen were retrospective comparative studies (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) with the fourteenth paper not reporting exactly how the data accrual and analysis were performed (14) (Table 1). Eight studies either included or had separate data for matched patient cohorts, seven of which specifically indicated propensity score matching (PSM) (15,17,19,20,24,25,27), with the eighth study reporting that both cohorts were "matched" retrospectively with no statistical difference in any of the listed patient demographic data in the two cohorts (16).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Where reported, the operative technique for the RMVS was performed through a varying 2-to 5-centimeter anterolateral mini-thoracotomy and varying number of other access ports. Eleven studies reported the robotic surgical platform used (14)(15)(16)18,19,(21)(22)(23)(24)26,27), all of which used the da Vinci ® Surgical System (Intuitive Surgical Inc., Sunnyvale, California, USA). Ten of the fourteen included studies reported the robotic cross clamp method.…”

Section: Operative Detailsmentioning

confidence: 99%

“…Ten of the fourteen included studies reported the robotic cross clamp method. Five reported using solely a transthoracic aortic cross clamp (14)(15)(16)22,24), while the other five studies either reported using endoaortic balloon or a transthoracic aortic cross clamp (19,20,23,25,26). Nine studies reported details on cardioplegia delivery with four utilizing antegrade cardioplegia delivery only (14,16,22,24) and five studies reporting using antegrade and/or retrograde cardioplegia (19,20,23,25,26).…”

Section: Operative Detailsmentioning

confidence: 99%

“…Five reported using solely a transthoracic aortic cross clamp (14)(15)(16)22,24), while the other five studies either reported using endoaortic balloon or a transthoracic aortic cross clamp (19,20,23,25,26). Nine studies reported details on cardioplegia delivery with four utilizing antegrade cardioplegia delivery only (14,16,22,24) and five studies reporting using antegrade and/or retrograde cardioplegia (19,20,23,25,26). Most procedures on the mitral valve were a mitral valve repair with 93.8% of patients in the RMVS group and 71.0% of the CSMVS group receiving a mitral valve repair.…”

Section: Operative Detailsmentioning

confidence: 99%

See 2 more Smart Citations

Robotic versus conventional sternotomy mitral valve surgery: a systematic review and meta-analysis

Williams¹,

Hwang²,

Huang³

et al. 2022

Ann Cardiothorac Surg

View full text Add to dashboard Cite

Background: Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS.Methods: An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS. Pre-defined primary outcomes of interest included all-cause mortality, cerebrovascular accidents (CVA) and re-operation for bleeding. Secondary outcomes of interest included cross clamp time, cardiopulmonary bypass (CPB) time, intensive care unit (ICU) and hospital length of stay (LOS), postoperative atrial fibrillation (POAF) and red blood cell (RBC) transfusion.Results: The search strategy identified fourteen studies qualifying for inclusion in this meta-analysis comparing RMVS to CSMVS. The outcomes of 6,341 patients (2,804 RMVS and 3,537 CSMVS) were included. RMVS had significantly lower mortality when compared to CSMVS group in both the unmatched [odds ratio (OR) 0.33; 95% confidence interval (CI): 0.19-0.57; P<0.001] and matched cohorts (OR 0.35; 95% CI: 0.15-0.80; P=0.01). There was no significant difference in rates of CVA or re-operation for bleeding between the two groups in either the entire included cohort or matched patients. CSMVS had significantly shorter cross clamp time by 28 minutes (95% CI: 19.30-37.32; P<0.001) and CPB time by 49 minutes (95%

show abstract

Propensity-matched analysis of robotic versus sternotomy approaches for mitral valve replacement

Yan

Wang

et al. 2023

J Robotic Surg

View full text Add to dashboard Cite

To compare early and medium-term outcomes between robotic and sternotomy approaches for mitral valve replacement (MVR). Clinical data of 1393 cases who underwent MVR between January 2014 and January 2023 were collected and stratified into robotic MVR (n = 186) and conventional sternotomy MVR (n = 1207) groups. The baseline data of the two groups of patients were corrected by the propensity score matching (PSM) method. After matching, the baseline characteristics were not significant different between the two groups (standardized mean difference < 10%). Moreover, the rates of operative mortality (P = 0.663), permanent stroke (P = 0.914), renal failure (P = 0.758), pneumonia (P = 0.722), and reoperation (P = 0.509) were not significantly different. Operation, CPB and cross-clamp time were shorter in the sternotomy group. On the other hand, ICU stay time, post-operative LOS, intraoperative transfusion, and intraoperative blood loss were shorter or less in the robot group. Operation, CPB, and cross-clamp time in robot group were all remarkably improved with experience. Finally, all-cause mortality (P = 0.633), redo mitral valve surgery (P = 0.739), and valve-related complications (P = 0.866) in 5 years of follow-up were not different between the two groups. Robotic MVR is safe, feasible, and reproducible for carefully selected patients with good operative outcomes and medium-term clinical outcomes.

show abstract

Comparison of postoperative outcomes between robotic mitral valve replacement and conventional mitral valve replacement

Cited by 11 publications

References 24 publications

Routine minimally invasive approach via left anterior mini‐thoracotomy in multivessel coronary revascularization

Routine minimally invasive approach via left anterior mini‐thoracotomy in multivessel coronary revascularization

Robotic versus conventional sternotomy mitral valve surgery: a systematic review and meta-analysis

Propensity-matched analysis of robotic versus sternotomy approaches for mitral valve replacement

Contact Info

Product

Resources

About