Robotically assisted mitral valve replacement

Gao, Changqing; Yang, Ming; Xiao, Chen; Wang, Gang; Wu, Yaling; Wang, Jiali; Li, Jiachun

doi:10.1016/j.jtcvs.2012.01.045

Cited by 48 publications

(28 citation statements)

References 10 publications

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“…In this series, five mitral valves were considered irreparable and replacement was performed. The benefits of robotic mitral valve replacement include smaller thoracotomy, better visualization and exposure of the valve, and easier suture handling in difficult anatomy (11).…”

Section: Discussionmentioning

confidence: 99%

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Robotic cardiac surgery in Brazil

Poffo

Toschi

Pope

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci ® robotic system was performed in LatinAmerica. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil.Methods: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery. Twenty-seven patients were male (69.2%), with the mean age of 51.3±17.9 years. Participants had a mean ejection fraction of 62±5%. The procedures included in this study were mitral valve surgery, surgical treatment of atrial fibrillation, atrial septal defect closure, resection of intra-cardiac tumors, totally endoscopic coronary artery bypass and pericardiectomy.Results: The mean time spent on cardiopulmonary bypass (CPB) during RCS was 154.9±94.2 minutes and the mean aortic cross-clamp time was 114.48±75.66 minutes. Thirty-two patients (82%) were extubated in the operating room immediately after surgery. The median intensive care unit (ICU) length of stay was 1 day (ranging from 0 to 25) and the median hospital length of stay was 5 days (ranging from 3 to 25). For each type of procedure, endpoints were individually reported. There were no conversions to sternotomy and no intra-operative complications. Patient follow-up was complete in 100% of the participants, with two early deaths unrelated to the procedures and no re-operations at mid-term.Conclusions: Despite the heterogeneity of this series, RCS appears to be feasible, safe and effective when used for the correction of various intra-and extra-cardiac pathologies. Adopting the robotic system has been a challenge in Brazil, where its limited clinical application may be related to the lack of specific training and the high cost of technology.

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Section: Discussionmentioning

confidence: 99%

“…Surgical access for ASD repair was similar to the approach used in robotic-assisted mitral valve surgery (11). In ASD repair, the right atrial chamber was accessed after isolation of the superior and inferior venae cavae.…”

Section: Correction Of Atrial Septal Defectmentioning

confidence: 99%

Robotic cardiac surgery in Brazil

Poffo

Toschi

Pope

et al. 2017

Ann. Cardiothorac. Surg.

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“…Since right atriotomy through the right chest had provided us with excellent and reliable exposure of the right heart and the left atrium for robotic repair of ASD [3], VSD [2,5], mitral valve [6], atrial mass [7,8], and PS (data not published), the initial attempt of novel robotic repair of AVSD via right atriotomy was made with success. The long operation time was thought to be a shortcoming of robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

Totally robotic repair of atrioventricular septal defect in the adult

Gao

Yang

Xiao

et al. 2015

J Cardiothorac Surg

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Background: Atrioventricular septal defect (AVSD) accounts for up to 3 % of congenital cardiac defects, which is routinely repaired via median sternotomy. Minimally invasive approach such as endoscopic or robotic assisted repair for AVSD has not been reported in the literature. With the experience with robotic mitral valve surgery and congenital defect repair, we initiated robotic AVSD repair in adults. Case Presentation: In this report, we presented three cases of successful repair of partial and intermediate AVSD by using da Vinci SI surgical system (Intuitive Surgical, Inc., Sunnyvale, CA). Conclusions: Totally robotic AVSD repair via right atriotomy could be safely performed in adults and it may provide superior cosmesis with the comparable surgical outcome of the repair via sternotomy.

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“…With the development of the technique, our dissection of the intercostal spaces is minimal and corresponding for the size of the incision in the skin, and the removal of the intercostal space is limited, avoiding trauma to the ribs and thereby decreasing postoperative pain. Some centers advocate the use of video or robotic systems for performing these surgeries [4,9,11]. In Brazil, Poffo et al [11] reported their experience of minimally invasive surgeries with the aid of video, including being performed a pioneering procedure by periareolar access.…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive surgeries refer to a variety of infusion techniques and visualization, allowing to perform surgeries with smaller incisions [4][5][6][7]. From the early 1990s, several authors began to advocate the use of these techniques, which have become the preferred approach for repair and valve replacement in a few specialized centers [1].…”

Section: Introductionmentioning

confidence: 99%

Initial experience with minimally invasive cardiac operations

Costa

Winter

Ferreira

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Background: Minimally invasive cardiovascular operations have been proposed as an alternative method to correct several cardiac congenital and acquired heart diseases, with the aim to reduce morbidity and mortality.Objectives: Describe the two years initial experience with minimally invasive operations, with emphasis on technical aspects and the learning curve.Methods: Between July 2009 and March 2012, 95 patients were operated using minimally invasive operations. Mean age was 55 ± 15 years and 53% were females. The operations performed were atrial septal defect closure (25), aortic valve replacement (32), mitral valve repair (23), mitral valve replacement (12), excision of atrial myxoma (2) and resection of subaortic membrane (1). The incision was a mini right thoracotomy in 87 cases and ministernotomy in 8.Results: Early mortality was 4.2%. Mean size of the incision was 6.3 ±1.2 cm. Extension of the original thoracotomy was necessary in only one case. Two patients suffered a stroke, and the mean total blood loss was 470 ± 277 ml. There were no cases of incision infection and 67% the patients had no major morbidity. Conclusions

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Robotically assisted mitral valve replacement

Abstract: Robotically assisted mitral valve replacement can be performed safely in patients with isolated mitral valve stenosis, and surgical results are excellent.

Cited by 48 publications

References 10 publications

Robotic cardiac surgery in Brazil

Robotic cardiac surgery in Brazil

Totally robotic repair of atrioventricular septal defect in the adult

Initial experience with minimally invasive cardiac operations

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