Robotic Mitral Valve Repair Through Nonresectional Posterior Leaflet Remodeling

Agnino, Alfonso; Anselmi, Amédéo

doi:10.1177/1556984520918960

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…Cross aortic clamping was achieved with an external Chitwood device or an endoaortic balloon according to the patient’s anatomical characteristics. Different surgical techniques were employed for MV repair, including quadrangular or triangular resection of the posterior leaflet, sliding, edge to edge, neo-chordae implant, and the “Lavaredo technique” [ 11 ]. Annuloplasty with semi-rigid or flexible ring was performed in all patients.…”

Section: Methodsmentioning

confidence: 99%

Learning Curve Analysis of Robotic-Assisted Mitral Valve Repair with COVID-19 Exogenous Factor: A Single Center Experience

Giroletti,

Brembilla,

Graniero

et al. 2023

Medicina

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Background and objective Renewed interest in robot-assisted cardiac procedures has been demonstrated by several studies. However, concerns have been raised about the need for a long and complex learning curve. In addition, the COVID-19 pandemic in 2020 might have affected the learning curve of these procedures. In this study, we investigated the impact of COVID-19 on the learning curve of robotic-assisted mitral valve surgery (RAMVS). The aim was to understand whether or not the benefits of RAMVS are compromised by its learning curve. Materials and Methods Between May 2019 and March 2023, 149 patients underwent RAMVS using the Da Vinci® X Surgical System at the Humanitas Gavazzeni Hospital, Bergamo, Italy. The selection of patients enrolled in the study was not influenced by case complexity. Regression models were used to formalize the learning curves, where preoperative data along with date of surgery and presence of COVID-19 were treated as the input covariates, while intraoperative and postoperative data were analyzed as output variables. Results The age of patients was 59.1 ± 13.3 years, and 70.5% were male. In total, 38.2% of the patients were operated on during the COVID-19 pandemic. The statistical analysis showed the positive impact of the learning curve on the trend of postoperative parameters, progressively reducing times and other key indicators. Focusing on the COVID-19 pandemic, statistical analysis did not recognize an impact on postoperative outcomes, although it became clear that variables not directly related to the intervention, especially ICU hours, were strongly influenced by hospital logistics during COVID-19. Conclusions Understanding the learning curve of robotic surgical procedures is essential to ensure their effectiveness and benefits. The learning curve involves not only surgeons but also other health care providers, and establishing a stable team in the early stage, as in our case, is important to shorten the duration. In fact, an exogenous factor such as the COVID-19 pandemic did not affect the robotic program despite the fact that the pandemic occurred early in the program.

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Section: Methodsmentioning

confidence: 99%

Learning Curve Analysis of Robotic-Assisted Mitral Valve Repair with COVID-19 Exogenous Factor: A Single Center Experience

Giroletti,

Brembilla,

Graniero

et al. 2023

Medicina

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“…In most patients in both groups, we adopted the "Lavaredo Technique" and the implantation of a complete ring for mitral valve repair. Tis previously described approach [13,14], which briefy consists of free-margin suturing of the mitral leafet, has been shown to be safe and efective at follow-up and has been used indiscriminately in the MIMVS and RMVS [15].…”

Section: Surgicalmentioning

confidence: 99%

Impact of COVID-19 in the Age of Computer-Assisted Surgery: Cost and Effectiveness Comparison between Robotic and Minimally Invasive Mitral Valve Surgery in a Single-Center Experience

Giroletti,

Salvi,

Peluso

et al. 2024

Journal of Cardiac Surgery

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Background. We conducted a cost and effectiveness analysis comparing robotic vs minimally invasive mitral valve surgery (RMVS vs MIMVS). The aim was to assess whether the higher cost of the robotic technique could be mitigated by the clinical advantages. Methods. We included 118 patients undergoing RMVS and 233 patients undergoing MIMVS. Initially, RMVS experience was developed during the COVID-19 pandemic. A propensity score matching analysis was performed. Postoperative outcomes and cost of care were compared. Results. RMVS patients had significantly shorter ICU and hospital lengths of stay. They also had a significantly earlier return to home. The cost of the total hospitalization and healthcare services were also significantly lower. Conclusion. Shorter hospitalization and lower cost of postoperative healthcare services may mitigate the initial investment cost to purchase and maintain the robot. These benefits are all the more relevant considering that several RMVS treatments were carried out during the COVID-19 pandemic.

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Robotic Mitral Valve Repair Through Nonresectional Posterior Leaflet Remodeling

Cited by 2 publications

References 6 publications

Learning Curve Analysis of Robotic-Assisted Mitral Valve Repair with COVID-19 Exogenous Factor: A Single Center Experience

Learning Curve Analysis of Robotic-Assisted Mitral Valve Repair with COVID-19 Exogenous Factor: A Single Center Experience

Impact of COVID-19 in the Age of Computer-Assisted Surgery: Cost and Effectiveness Comparison between Robotic and Minimally Invasive Mitral Valve Surgery in a Single-Center Experience

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