Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective
Objective: Despite the recent increase in the use of minimally invasive approaches to mitral valve surgery in patients with a prior sternotomy, the outcomes of the robotic approach to mitral valve surgery in this patient population have not been examined. Methods: We retrospectively reviewed 342 con...
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Elsevier
2022-06-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250722001043 |
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| author | Talia G. Meidan, BS Allison T. Lanfear, BS John J. Squiers, MD Mohanad Hamandi, MD Bruce W. Lytle, MD J. Michael DiMaio, MD Robert L. Smith, MD Timothy J. George, MD Kelley A. Hutcheson, MD Emily Shih, MD Allison I. Aldrich, BS Lena Hasson, MD Sri Charitha Koneru, MD |
| author_facet | Talia G. Meidan, BS Allison T. Lanfear, BS John J. Squiers, MD Mohanad Hamandi, MD Bruce W. Lytle, MD J. Michael DiMaio, MD Robert L. Smith, MD Timothy J. George, MD Kelley A. Hutcheson, MD Emily Shih, MD Allison I. Aldrich, BS Lena Hasson, MD Sri Charitha Koneru, MD |
| author_sort | Talia G. Meidan, BS |
| collection | DOAJ |
| description | Objective: Despite the recent increase in the use of minimally invasive approaches to mitral valve surgery in patients with a prior sternotomy, the outcomes of the robotic approach to mitral valve surgery in this patient population have not been examined. Methods: We retrospectively reviewed 342 consecutive patients who underwent mitral valve surgery after a prior sternotomy between 2013 and 2020, in which the robotic approach was used in 21 patients (6.1%). We reviewed the clinical details of these 21 patients. Results: The median age was 71 years [interquartile range 64.00, 74.00 years], and mean Society of Thoracic Surgeons Predicted Risk of Mortality was 4.2% ± 3.8%. The indication for mitral valve surgery was degenerative mitral valve disease in 33.3% (7/21), functional disease in 28.6% (6/21), mixed disease in 4.8% (1/21), rheumatic disease in 9.5% (2/21), and failed repair for degenerative disease in 23.8% (5/21). No cases required conversion from robotic assistance to alternative approaches, there were no intraoperative deaths, and intraoperative transesophageal echocardiogram confirmed complete elimination of mitral regurgitation in 90.5% (19/21) of cases. Thirty-day mortality was 0.0% (0/21), and 1-year mortality was 4.8% (1/21). There were no strokes or wound infections at 30 days, and 14.3% (3/21) of patients received intraoperative blood product transfusions. Conclusions: The results of this retrospective review suggest that the robotic approach to mitral valve surgery in patients with a prior sternotomy is safe in experienced hands. Although some centers have considered prior sternotomy a relative contraindication to robotic mitral valve surgery, this approach is feasible and can be considered an option for experienced surgeons. |
| format | Article |
| id | doaj-art-dc7e5ab125ac4910b5e7bbf4888d3c28 |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-dc7e5ab125ac4910b5e7bbf4888d3c282025-08-20T03:36:37ZengElsevierJTCVS Techniques2666-25072022-06-0113465110.1016/j.xjtc.2022.01.023Robotic mitral valve surgery after prior sternotomyCentral MessagePerspectiveTalia G. Meidan, BS0Allison T. Lanfear, BS1John J. Squiers, MD2Mohanad Hamandi, MD3Bruce W. Lytle, MD4J. Michael DiMaio, MD5Robert L. Smith, MD6Timothy J. George, MD7Kelley A. Hutcheson, MD8Emily Shih, MD9Allison I. Aldrich, BS10Lena Hasson, MD11Sri Charitha Koneru, MD12Baylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, Tex; Address for reprints: Talia G. Meidan, BS, Baylor Scott & White The Heart Hospital – Plano, 1100 Allied Dr, Plano, TX 75093.Baylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexBaylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexBaylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital – Plano, Plano, TexDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital – Plano, Plano, TexDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital – Plano, Plano, TexDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital – Plano, Plano, TexDepartment of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital – Plano, Plano, TexBaylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexBaylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexBaylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexBaylor Scott & White Research Institute, Baylor Scott & White The Heart Hospital – Plano, Plano, TexObjective: Despite the recent increase in the use of minimally invasive approaches to mitral valve surgery in patients with a prior sternotomy, the outcomes of the robotic approach to mitral valve surgery in this patient population have not been examined. Methods: We retrospectively reviewed 342 consecutive patients who underwent mitral valve surgery after a prior sternotomy between 2013 and 2020, in which the robotic approach was used in 21 patients (6.1%). We reviewed the clinical details of these 21 patients. Results: The median age was 71 years [interquartile range 64.00, 74.00 years], and mean Society of Thoracic Surgeons Predicted Risk of Mortality was 4.2% ± 3.8%. The indication for mitral valve surgery was degenerative mitral valve disease in 33.3% (7/21), functional disease in 28.6% (6/21), mixed disease in 4.8% (1/21), rheumatic disease in 9.5% (2/21), and failed repair for degenerative disease in 23.8% (5/21). No cases required conversion from robotic assistance to alternative approaches, there were no intraoperative deaths, and intraoperative transesophageal echocardiogram confirmed complete elimination of mitral regurgitation in 90.5% (19/21) of cases. Thirty-day mortality was 0.0% (0/21), and 1-year mortality was 4.8% (1/21). There were no strokes or wound infections at 30 days, and 14.3% (3/21) of patients received intraoperative blood product transfusions. Conclusions: The results of this retrospective review suggest that the robotic approach to mitral valve surgery in patients with a prior sternotomy is safe in experienced hands. Although some centers have considered prior sternotomy a relative contraindication to robotic mitral valve surgery, this approach is feasible and can be considered an option for experienced surgeons.http://www.sciencedirect.com/science/article/pii/S2666250722001043robotic mitral valve surgeryprior sternotomyredo sternotomymitral valvereoperation |
| spellingShingle | Talia G. Meidan, BS Allison T. Lanfear, BS John J. Squiers, MD Mohanad Hamandi, MD Bruce W. Lytle, MD J. Michael DiMaio, MD Robert L. Smith, MD Timothy J. George, MD Kelley A. Hutcheson, MD Emily Shih, MD Allison I. Aldrich, BS Lena Hasson, MD Sri Charitha Koneru, MD Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective JTCVS Techniques robotic mitral valve surgery prior sternotomy redo sternotomy mitral valve reoperation |
| title | Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective |
| title_full | Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective |
| title_fullStr | Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective |
| title_full_unstemmed | Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective |
| title_short | Robotic mitral valve surgery after prior sternotomyCentral MessagePerspective |
| title_sort | robotic mitral valve surgery after prior sternotomycentral messageperspective |
| topic | robotic mitral valve surgery prior sternotomy redo sternotomy mitral valve reoperation |
| url | http://www.sciencedirect.com/science/article/pii/S2666250722001043 |
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