Robotic mitral valve repair: A single center experience over a 7‐year period

Klepper, Maureen; Noirhomme, Philippe; Kerchove, Laurent de; Mastrobuoni, Stefano; Spadaccio, Cristiano; Lemaire, Guillaume; Khoury, Gébrine El; Navarra, Emiliano

doi:10.1111/jocs.16575

Cited by 4 publications

(13 citation statements)

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“…Another study which reported mid-to long-term results after endoscopic robotic mitral valve surgery in 1,257 patients by Murphy and colleagues was excluded as 7% of patients underwent mitral valve replacement (not repair) and therefore did not meet inclusion criteria. Therefore, nine studies remained after fulfilling the pre-determined inclusion criteria (21)(22)(23)(24)(25)(26)(27)(28)(29), with a total of 3,300 patients undergoing RMVr.…”

Section: Resultsmentioning

confidence: 99%

“…Eight of the nine included studies were retrospective observational case series or cohort studies (21,22,(24)(25)(26)(27)(28)(29), with only one study being prospective in nature (23) (Table 1). One of the included studies was a comparative cohort study comparing RMVr to conventional sternotomy (24), therefore, only data regarding the robotic group was included in the present study.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic review and meta-analysis of mid-term survival, reoperation, and recurrent mitral regurgitation for robotic-assisted mitral valve repair

Williams¹,

Eranki²,

Mamo³

et al. 2022

Ann Cardiothorac Surg

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Background: Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid-to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid-to long-term data for RMVr.Methods: Electronic searches of five databases were performed to identify all relevant studies reporting minimum five-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and from moderate or worse mitral regurgitation (MR) at five-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data.Results: Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5-and 10-year were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at eight-years post RMVr was 95.0%. Freedom from moderate or worse MR at seven-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively.Conclusions: RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available midterm data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and from moderate or worse MR recurrence.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Systematic review and meta-analysis of mid-term survival, reoperation, and recurrent mitral regurgitation for robotic-assisted mitral valve repair

Williams¹,

Eranki²,

Mamo³

et al. 2022

Ann Cardiothorac Surg

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“…The potential impact of ethnicity on robotic mitral valve repair Dear Editor, We read the article "Robotic mitral valve repair: A single center experience over a 7-year period," by Dr Maureen Klepper et al 1 with great interest. The main limitation identified in this report was the lack of consideration regarding the impact of ethnicity on outcomes following robotic mitral valve repair.…”

mentioning

confidence: 99%

“…Outcomes of the earliest and latest patients are compared. 1 The study identifies the following patient characteristics: Gender, age, BMI, co-morbidities, and smoking history. Although these factors are important in considering outcomes post valve repair, we believe that the impact of ethnicity following surgery should be further investigated.…”

mentioning

confidence: 99%

“…The article concludes that developing a robotic mitral repair program is achievable without compromising the effectiveness and safety of repair. 1 However, it is important to consider ethnicity as a demographic factor, as this will account for a potential confounding variable present in the study. Additionally, measurement of ethnic minority uptake of robotic surgery may guide a more inclusive approach for future programs.…”

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The potential impact of ethnicity on robotic mitral valve repair

Kabuli

Akbari

Alam

2022

Journal of Cardiac Surgery

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Robotic mitral valve repair—the Bruxelles experience

Aphram¹,

Melina²,

Noirhomme³

et al. 2022

Ann Cardiothorac Surg

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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 years 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 to treat 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 the complexity of the valve lesion.

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Robotic mitral valve repair: A single center experience over a 7‐year period

Abstract: Background: We report the clinical and echocardiographic results of our experience in robotic mitral valve repair over a 7-year period. The outcomes of the earliest and the latest patients will be compared.

Cited by 4 publications

References 23 publications

Systematic review and meta-analysis of mid-term survival, reoperation, and recurrent mitral regurgitation for robotic-assisted mitral valve repair

Systematic review and meta-analysis of mid-term survival, reoperation, and recurrent mitral regurgitation for robotic-assisted mitral valve repair

The potential impact of ethnicity on robotic mitral valve repair

Robotic mitral valve repair—the Bruxelles experience

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