Annals of Thoracic Surgery
Annals of Thoracic Surgery
5 years ago

Repeat Robotic Endoscopic Mitral Valve Surgery: A Safe and Effective Strategy

Mitral valve reoperation is necessary in a finite percent of patients. With growth in robotic mitral valve surgery, reoperative strategies need to be developed. A review of institutional mitral valve re-operations after a previous robotic approach was undertaken. Methods From January 2006 through April 2017, 1853 patients underwent an initial robotic mitral valve surgery by a dedicated robotic team. Fifty-four (2.9%) of these patients required mitral reoperation at our institution over this time period. A retrospective review of prospectively collected operative, echocardiographic, videoscopic, and outcome data was performed on this patient group to assess the feasibility, efficacy, and safety of repeat robotic mitral valve surgery. Results Reoperative mitral surgery after a previous robotic procedure was completed robotically in 50 (92.6%) patients. Robotic mitral re-repair was achieved in 36 (72%) of the 50 patients, including 33 (85%) of the 39 patients with degenerative disease. Conversion of a previous repair to a replacement was performed in 12 (24%) patients, and re-replacement in 2 (4%) patients. No patients were converted from a robotic approach to a thoracotomy or sternotomy approach. There were no deaths or strokes in this series and major morbidity occurred in 1 patient (2%) in the repeat robotic group. Four (7%) patients required sternotomy for reoperation due to right chest access or peripheral perfusion limitations. Conclusions Repeat robotic mitral surgery after a previous robotic approach is feasible, and appears to be an effective and safe strategy in a high percentage of patients when performed by an experienced robotic team.

Publisher URL: www.sciencedirect.com/science

DOI: S0003497518300833

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