Robotic repair for Barlow mitral regurgitation: Repairability, safety, and durability

Rowe, Georgina; Gill, George; Trento, Alfredo; Emerson, Dominic; Roach, Amy; Peiris, A.; Cheng, Wen; Egorova, Natalia; Chikwe, Joanna

doi:10.1016/j.jtcvs.2022.05.033

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…These long‐term outcomes were comparable to the sternotomy data published in previous reports 29,30 . Some centers have assessed the feasibility of robotic‐assisted MIMVS in a wide range of mitral pathologies with more complex repair techniques (e.g., bileaflet repair, mitral annular calcification excision) 31–33 . Fujita et al reported that patients who underwent robotic‐assisted MIMVS had a higher complexity score requiring more complex repairs than patients undergoing mini‐thoracotomy MIMVS 32 .…”

supporting

confidence: 69%

“…29,30 Some centers have assessed the feasibility of robotic-assisted MIMVS in a wide range of mitral pathologies with more complex repair techniques (e.g., bileaflet repair, mitral annular calcification excision). [31][32][33] Fujita et al reported that patients who underwent robotic-assisted MIMVS had a higher complexity score requiring more complex repairs than patients undergoing minithoracotomy MIMVS. 32 Neo-chord implantation was attempted more in robotic-assisted MIMVS though procedure times did not differ between the two groups.…”

mentioning

confidence: 99%

“…conducted robotic MIMVS for Barlow type mitral disease with 5year freedom from greater than moderate mitral regurgitation of 92%, which was similar to non-Barlow disease. 33 In our own practice, the senior author has been performing sternal sparing mitral valve surgery since 2003 which began as a minithoracotomy approach and gradually transitioned to an all-robotic approach around 2010. The impetus to moving to a robotic approach was to minimize the size of the ports and transition to a truly endoscopic procedure while adding the benefits of dexterity and improved visualization.…”

mentioning

confidence: 99%

“…Neo‐chord implantation was attempted more in robotic‐assisted MIMVS though procedure times did not differ between the two groups. Regarding complexity, Rowe et al conducted robotic MIMVS for Barlow type mitral disease with 5‐year freedom from greater than moderate mitral regurgitation of 92%, which was similar to non‐Barlow disease 33 …”

mentioning

confidence: 99%

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Minimally invasive mitral valve surgery with or without robotics: Examining the evidence

Kuwabara

Balkhy

2022

Journal of Cardiac Surgery

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Minimally invasive mitral valve surgery can be performed with or without robotic assistance. In this issue of the journal, Zheng et al. compare between these two approaches in a propensity‐matched study over a 5‐year period and show that the two techniques have similar successful short and mid‐term outcomes. Although we are proponents of the robotic approach, we agree with their conclusions and discuss in this commentary some of the previously published studies that have shown similar findings.

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supporting

confidence: 69%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Minimally invasive mitral valve surgery with or without robotics: Examining the evidence

Kuwabara

Balkhy

2022

Journal of Cardiac Surgery

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“…The minimally invasive approach in patients suffering from Barlow’s disease still remains a certain surgical challenge. Data from larger series are scarce [ 17 ]. We present the results of a large representative cohort of Barlow patients.…”

Section: Discussionmentioning

confidence: 99%

Five-year outcomes of different techniques for minimally invasive mitral valve repair in Barlow’s disease

Pölzl,

Gollmann-Tepeköylü,

Nägele

et al. 2024

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Barlow’s disease is a specific sub-form of mitral valve (MV) disease, characterized by diffuse excessive tissue and multi segment prolapse. The anterolateral mini-thoracotomy represents the standard access for MV regurgitation in many centers. It still remains unclear which surgical technique provides the best results. Therefore, the aim of this study was to compare operative safety and mid-term outcomes after (a) isolated annuloplasty, (b) use of additional artificial chordae or (c) leaflet resection in patients suffering from Barlow’s disease undergoing minimally invasive mitral valve repair. METHODS A consecutive series of patients suffering from Barlow`s disease undergoing minimally invasive mitral valve surgery (MIMVS) between 2001–2020 were analyzed (n = 246). Patients were grouped and analyzed according to the used surgical technique. The primary outcome was a modified Mitral Valve Academic Research Consortium combined end-point of mortality, reoperation due to repair failure or reoccurrence of severe mitral regurgitation within 5 years. The secondary outcome included operative success and safety up to 30 days. RESULTS No significant difference was found between the three surgical techniques in regard to the operative safety (p-value = 0.774). The primary outcome did not differ between groups (p-value = 0.244). Operative success was achieved in 93.5% and was lowest in the isolated annuloplasty group (77.1%). Conversion to mitral valve replacement was increased in patients undergoing isolated annuloplasty (p-value < 0.001). CONCLUSIONS Isolated annuloplasty, use of additional artificial chordae and leaflet resection represent feasible techniques in Barlow patients undergoing MIMVS with comparable five-year results. In view of the increased conversion rate in the annuloplasty group, the pathology should not be oversimplified.

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Commentary: Robotic mitral repair: The “new gold-standard” that requires more gold

Wan

Qiang

Wang

2024

The Journal of Thoracic and Cardiovascular Surgery

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Robotic repair for Barlow mitral regurgitation: Repairability, safety, and durability

Cited by 4 publications

References 19 publications

Minimally invasive mitral valve surgery with or without robotics: Examining the evidence

Minimally invasive mitral valve surgery with or without robotics: Examining the evidence

Five-year outcomes of different techniques for minimally invasive mitral valve repair in Barlow’s disease

Commentary: Robotic mitral repair: The “new gold-standard” that requires more gold

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