ABSTRACT
Minimally invasive, robotic-assisted cardiac surgery has been shown to decrease transfusion rates, decrease wound infection rates, shorten hospital length of stay, and allow for a faster return to full activity compared with traditional sternotomy approaches. However, its application has chiefly been limited to primary, isolated procedures such as primary mitral valve repair or replacement. We describe the first reported use of a robotic surgery platform to perform reoperative mitral valve replacement using a minimally invasive, totally endoscopic, port-access approach.
Subject(s)
Cardiac Surgical Procedures/methods , Heart Valve Prosthesis Implantation/methods , Minimally Invasive Surgical Procedures/methods , Mitral Valve Insufficiency/surgery , Mitral Valve/surgery , Robotic Surgical Procedures/methods , Cardiopulmonary Bypass/methods , Cardiopulmonary Bypass/standards , Echocardiography, Transesophageal/methods , Humans , Male , Middle Aged , Mitral Valve Insufficiency/diagnostic imaging , Reoperation , Treatment OutcomeABSTRACT
Closure of the left atrial appendage (LAA) has become a standard part of any mitral valve operation because it is thought to reduce the potential for late thrombus development and for embolic events. To date, surgeons performing robotic mitral valve operations have been limited to an endocardial approach to LAA closure. However, oversewing the orifice of the LAA is time consuming and lengthens the cross-clamp time, and failures to obtain permanent closure have been reported. We describe our technique for an epicardial approach that is safe and efficient and that gives a secure closure of the LAA.
