2021 Volume 91 Issue 1 Pages 114-120
Background: Robotic-assisted mitral valve plasty (RMVP) was introduced in Japan in 2018. However, its clinical outcomes and learning curve have not been fully discussed.
Objective: This study aimed to assess the clinical outcomes and learning curve of RMVP in its first 100 cases.
Methods: This study retrospectively analyzed the clinical records of 100 patients who underwent RMVP between June 2018 and October 2020.
Results: The mean age was 65±14 years, 46 patients were female, and the body surface area was 2.0±0.2. EuroSCORE II was 2.0±1.8. Thirty (30%) patients had New York Heart Association Class III or IV. The mean ejection fraction was 61.7%±8.3%. Chronic heart failure occurred in 22 patients (22%). Diabetes medications were prescribed in 13 patients (13%), and nine patients had infective endocarditis in (8 were healed and 1 was active). The median operation, cardiopulmonary bypass, and aortic cross-clamp times were 236±47, 163±39, and 131±34 min, respectively. Concomitant procedures included maze (21%), left arterial appendage closure (32%), and patent foramen ovale closure (5%). Repair techniques included the NeoChord technique (53%), leaflet resection/suture (43%), edge-to-edge repair (18%), and folding plasty (24%). No in-hospital or 30-day mortality was recorded. Complications included reexploration (n=1, 1%), stroke (n=1, 3%), subarachnoid hemorrhage (n=1, 1%), postoperative hemolysis (n=3, 3%). One patient required surgical re-intervention due to moderate mitral regurgitation (1%). On echocardiography before discharge, the mitral regurgitation was graded as less than mild in 96 patients (96%). The learning curves of the operation time, cardiopulmonary bypass time, and aortic cross-clamp time did not plateau in 100 cases.
Conclusions: The clinical outcomes of the initial 100 cases of RMVP were satisfactory, but more than 100 cases are required to achieve a stable operative time.
