Unilateral percutaneous cannulation and endoaortic balloon management in robotic-assisted cardiac surgery: The least invasive approach

Amabile, Andrea; Hameed, Irbaz; Shang, Michael; LaLonde, Michael; Geirsson, Arnar; Krane, Markus

doi:10.1510/mmcts.2022.010

Cited by 3 publications

(4 citation statements)

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“…The least invasive strategy we offer to patients is percutaneous cannulation. We have previously presented its technical nuances in detail ( 12 ). Notably, the transition from open to percutaneous cannulation was associated with a reduction in groin-related postoperative comorbidities; from 6.3% in the open femoral cannulation group to 1.8% in the percutaneous cannulation group, at no difference in terms of median arterial cannula size (21 mm in both groups).…”

Section: Discussionmentioning

confidence: 99%

Two hundred robotic mitral valve repair procedures for degenerative mitral regurgitation: the Yale experience

Amabile¹,

Morrison²,

LaLonde³

et al. 2022

Ann Cardiothorac Surg

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Background: Robotic surgery has gained popularity over the past two decades due to the benefits related to smaller surgical incisions, enhanced technical dexterity and better intraoperative visualization. We present the Yale experience of the first two hundred totally endoscopic, robotic-assisted mitral valve repair procedures for the treatment of degenerative mitral regurgitation.Methods: We performed a retrospective cohort study of patients undergoing totally endoscopic, roboticassisted isolated or concomitant mitral valve repair for degenerative mitral regurgitation at Yale-New Haven Hospital from October 2018 to April 2022. Mitral valve repair procedures for rheumatic or secondary functional mitral regurgitation and planned robotic-assisted mitral valve replacement cases were excluded.Results: Two hundred consecutive procedures were performed. The median age was 65 years (interquartile range, 58-73 years). Six patients (3.0%) had a history of mediastinal radiation, four patients (2.0%) had previous cardiac surgery, and one patient (0.5%) had cardiac dextroversion. Median cardiopulmonary bypass and aortic cross-clamp times were 122 and 79 minutes, respectively. Femoral vessel cannulation was performed percutaneously in 57 (28.5%) patients with no major access-site related complication. Aortic cross-clamping was performed with the endoaortic balloon occlusion device in 151 (75.5%) patients. No conversions to sternotomy occurred. Satisfactory repair was achieved in 100% of cases, with 184 (92.0%) and 16 (8.0%) of patients having trace/none or mild residual mitral regurgitation, respectively. Forty-two patients (21.0%) underwent concomitant Cox-maze procedure and 25 patients (12.5%) underwent concomitant tricuspid valve repair. Thirty-day mortality rate was 0.5%, with an observed-to-expected ratio of 0.53. Two patients (1.0%) underwent re-exploration for bleeding, one had early postoperative stroke (0.5%), five developed pneumothorax (2.5%) and two required dialysis for acute renal failure (1.0%). The median length of hospital stay was four days.Conclusions: Excellent short-term outcomes can be achieved in experienced centers for the treatment of degenerative mitral regurgitation with a totally endoscopic, robotic-assisted approach.

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Section: Discussionmentioning

confidence: 99%

Two hundred robotic mitral valve repair procedures for degenerative mitral regurgitation: the Yale experience

Amabile¹,

Morrison²,

LaLonde³

et al. 2022

Ann Cardiothorac Surg

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“…We had the opportunity to previously report our surgical technique for various procedures that targeted the mitral valve [28][29][30][31][32] , with excellent short-term outcomes [33] . We approach all our robotic mitral cases by placing the patient in a supine position on the operating table, with a rolled towel (or a gel pad) positioned under the right scapula and the ipsilateral arm loosely tucked slightly below the chest.…”

Section: A Technical Perspectivementioning

confidence: 99%

“…It is worth noting that we had the opportunity to perform robotic-assisted mitral valve repair on a patient with situs inversus and cardiac dextroversion, in which case we arranged the port configuration symmetrically on the left hemithorax [34] . We have also previously described our technique for unilateral percutaneous cannulation and endoaortic balloon management in robotic cases [31] , for approaching redo mitral valve procedures via totally endoscopic, robotic-assisted adhesiolysis and repair [30] , and for de-airing after robotic-assisted intracardiac procedures [35] .…”

Section: A Technical Perspectivementioning

confidence: 99%

State of the art and new frontiers in robotic mitral valve surgery

Amabile¹,

Ragnarsson²,

Krane³

et al. 2023

Art Int Surg

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“…We offered a totally endoscopic, robotic-assisted approach for redo mitral valve repair. After induction of general anesthesia, femoral percutaneous cannulation was performed 4 and robotic ports were placed in our standard fashion. 5 After careful intrathoracic adhesiolysis, 3 aortic endoclamping was achieved using the IntraClude intra-aortic occlusion device (Edwards Lifesciences), and the Waterston's groove was accessed.…”

Section: Case Videomentioning

confidence: 99%

Totally endoscopic, robotic-assisted redo mitral valve re-repair

Amabile,

Mori,

LaLonde

et al. 2023

JTCVS Techniques

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Unilateral percutaneous cannulation and endoaortic balloon management in robotic-assisted cardiac surgery: The least invasive approach

Cited by 3 publications

References 0 publications

Two hundred robotic mitral valve repair procedures for degenerative mitral regurgitation: the Yale experience

Two hundred robotic mitral valve repair procedures for degenerative mitral regurgitation: the Yale experience

State of the art and new frontiers in robotic mitral valve surgery

Totally endoscopic, robotic-assisted redo mitral valve re-repair

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