Robotically controlled video-assisted port-access mitral valve surgery.

Abstract

From 1997 to 2000, 221 patients underwent mitral valve surgery through a mini-thoracotomy, using a port-access endovascular cardiopulmonary bypass system in 38 and a transthoracic clamp in 183. In 120 patients, exposure of the mitral valve was facilitated by an endoscope attached to a voice-controlled robotic arm (AESOP 3000). The mitral valve was repaired in 26 patients and replaced in 195; 24 were redo cases. Operating time was 3.5 +/- 1.2 hours, aortic crossclamp time was 58 +/- 16 minutes, intensive care unit stay was 22 +/- 7 hours, and hospital stay was 6.4 +/- 1.2 days. Median postoperative blood loss was 332 +/- 104 mL. There was 1 hospital death. On follow-up at 16.4 +/- 12.2 months, there was no late death or reoperation. New York Heart Association functional class improved from 2.6 +/- 0.5 to 1.4 +/- 0.8. Use of video and robotic assistance minimized incision length and allowed visualization of the whole mitral valve apparatus. The transthoracic clamp facilitated aortic crossclamping and injection of cardioplegia. These findings indicate that the procedure is safe and effective and suggest advantages over conventional surgery in terms of cost, cosmesis, blood loss, postoperative discomfort, intensive care unit and hospital stay.

• Authors: Naresh Trehan, Yugal K Mishra, Mitesh Sharma, Surinder Bazaz, Yatin Mehta, Krishan Kant Sharma, Sameer Shrivastava
• Journal: Asian cardiovascular & thoracic annals (Asian Cardiovasc Thorac Ann) Vol. 10 Issue 2 Pg. 133-6 (Jun 2002) ISSN: 0218-4923 [Print] England
• PMID: 12079936 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Blood Loss, Surgical
• Female
• Follow-Up Studies
• Heart Valve Diseases (surgery)
• Humans
• Length of Stay
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures
• Mitral Valve (surgery)
• Robotics
• Video-Assisted Surgery (methods)