Introduction
This study aimed to evaluate the feasibility and efficacy of robotically
assisted, minimally invasive mitral valve surgery combined with left atrial
reduction for mitral valve surgery and elimination of atrial fibrillation
(AF).
Methods
Eleven patients with severe mitral regurgitation, AF, and left atrial
enlargement who underwent robotic, minimally invasive surgery between May
2013 and March 2018 were evaluated retrospectively. The da Vinci robotic
system was used in all procedures. The patients’ demographic data,
electrocardiography (ECG) findings, and pre- and postoperative transthoracic
echocardiography findings were analyzed. During follow up ECG was performed
at postoperative 3, 6, and 12 months additionally at the 3
rd
month trans thoracic echocardiography was performed and functional capacity
was also evaluated for all patients.
Results
All patients underwent robotic-assisted mitral valve surgery with
radiofrequency ablation and left atrial reduction. Mean age was
45.76±16.61 years; 7 patients were male and 4 were female.
Preoperatively, mean left atrial volume index (LAVI) was 69.55±4.87
mL/m
2
, ejection fraction (EF) was 54.62±8.27%, and
pulmonary artery pressure (PAP) was 45.75±9.42 mmHg. Postoperatively,
in hospital evaluation LAVI decreased to 48.01±4.91 mL/m
2
(
P
=0.008), EF to 50.63±10.13%
(
P
>0.05), and PAP to 39.02±3.11 mmHg
(
P
=0.012). AF was eliminated in 8 (72%) of the 11
patients at the 1
st
postoperative month. There were significant
improvements in functional capacity and no mortality during follow-up.
Conclusion
Left atrial reduction and radiofrequency ablation concomitant with
robotically assisted minimally invasive mitral valve surgery can be
performed safely and effectively to eliminate AF and prevent recurrence.