Robotic mitral valve replacement: a short-term single institution experience

This study evaluates the safety, efficacy, reproducibility and short-term clinical outcomes of robotic mitral valve replacement (MVR).

Between September 2022 and May 2024, 64 robotic cardiac and thoracic surgeries were performed in our institute. Twelve consecutive patients who underwent MVR using da Vinci Xi robotic system were retrospectively analysed. It was performed by right side approach using four instrument ports and one 4-cm working port, under peripheral cardiopulmonary bypass (CPB) with transoesophageal echocardiography (TEE) surveillance.

The mean age of patients was 39 ± 9 years (median = 42 years), male-to-female ratio of 1:2, left ventricular ejection fraction (LVEF) = 60 ± 5%. The mean CPB and aortic cross clamp (ACX) time was 273 ± 119 min (174–568 min) and 160 ± 91 min (85–395 min) respectively. All patients received mechanical valve. The ventilation time and length of intensive care unit (ICU) stay was 21 ± 8 h and 3 ± 2 days respectively. The median drain output was 258 ml (Interquartile Range (IQR) = 240–353ml). Two patients (16.67%) were re-explored the same day in view of excessive drain output. Two patients required postoperative opioid analgesics (16.67%). One (8.33%) patient had groin wound infection. There was no mortality. Patients were ambulated from postoperative day 3.91 ± 1.80 days. Duration of hospital stay post-surgery was 9 ± 3 days, and patients were discharged after therapeutic International Normalised Ratio (INR) of 3 was achieved. Postoperative pain score of study group was 3 ± 1 (mild). Patients were satisfied with aesthetically pleasing scar and returned to routine activity within 4 ± 1 weeks. The mean follow-up time was 10.17 ± 5.11 months.

Robotic MVR surgery is safe and has excellent short-term outcomes. Patients experienced less pain and faster recovery.