Robotic redo mitral valve replacement combined with dysfunctional amplatzer plug resection on a beating heart

Abstract

Redo-cardiac surgery is associated with high morbidity and mortality rates. Although redo surgery are relative contraindications for robotic surgery, robotic redo mitral valve surgery has been performed with endo-aortic occlusion techniques and on fibrillated heart successfully. Beating heart mitral valve surgery is another well-known option for redo cardiac surgery practice. Robotic beating heart surgery is not well-studied before. As a new point of view to robotic reoperation surgery, herein, we aimed to present a case who underwent redo robotic mitral valve replacement combined with dysfunctioned amplatzer plug resection on a beating heart.

Robotic‐assisted beating heart mitral valve surgery: Preliminary report

“…EAOB is undoubtedly a feasible choice for these patients, however, it poses serious, well‐known complication risks, mainly related to implantation and fixing challenges. In addition, a relative increase on dissection incidence, as well as CVE secondary to balloon migration, are other potential complications 4,7 . Therefore, in our patient group, we chose not to use EAOB due to potential complication risks.…”

“…However, air embolism risk is a major issue that should be considered in beating heart surgery. An aortic root vent catheter and continuous carbon dioxide (CO 2 ) insufflation (at a flow rate of 8–10 L/min) into the operative field, are two important steps that are already well known 3,4,11 . In addition, we defined three important steps for preventing of air embolism.…”

“…The DaVinci SI System (Intuitive Surgical) was used. Surgical set‐up almost exactly as we have detailed in our previous studies 4–6 . A dual‐lumen endotracheal tube was placed for one‐lung ventilation.…”

“…Those studies describe patients who had surgery done on an arrested heart using an endoaortic occlusion balloon (EAOB) 1,2 or surgery in a fibrillated heart 3 . More recently, a patient was successfully re‐operated with a robot‐assisted beating heart technique, following a dysfunctional prosthetic MV and serious paravalvular leak 4 …”

“…3 More recently, a patient was successfully re-operated with a robot-assisted beating heart technique, following a dysfunctional prosthetic MV and serious paravalvular leak. 4 In this study, we aimed to share our experiences and early results of robotic, beating heart MV surgery, and to discuss possible recommendations of this strategy.…”