Clifton T P Lewis1, Richard L Stephens2, Charles M Tyndal3, Jennifer L Cline4. 1. Division of Cardiac Surgery, Princeton Baptist Medical Center, Birmingham, Alabama. Electronic address: cliftonlewis1942@gmail.com. 2. Division of Cardiac Surgery, Princeton Baptist Medical Center, Birmingham, Alabama. 3. Division of Cardiovascular Perfusion, University of Alabama at Birmingham (UAB) Hospitals, Birmingham, Alabama. 4. Department of Surgery, Sarasota Memorial Hospital, Sarasota, Florida; Sarasota Vascular Specialists, Sarasota, Florida.
Abstract
BACKGROUND: Robotic mitral valve repair has been successfully performed since the late 1990s, but concomitant robotic tricuspid repair has not yet been widely adopted. We report our first 5 years' experience with concomitant robotic mitral-tricuspid valve repair. METHODS: Records were reviewed for all patients who underwent concomitant robotic mitral-tricuspid valve repair in a single practice. Cardiopulmonary bypass was performed with femoral cannulation, antegrade and retrograde cardioplegia, and aortic cross-clamping by balloon occlusion. Access was through 5 ports. Tricuspid repair techniques included De Vega, modified De Vega with annuloplasty band, and annuloplasty band with interrupted suture repair. RESULTS: From August 2006 to December 2011, 50 patients underwent concomitant robotic mitral-tricuspid valve repair. The mean age was 73.4±9.3 years, and all patients had mitral or tricuspid regurgitation grades of 2+ or greater preoperatively. Cross-clamp and cardiopulmonary bypass times decreased significantly with surgeon experience. There were no conversions to sternotomy and one conversion to mitral valve replacement. Six patients required reexploration for bleeding or hemothorax, most of them early in the series. There were no infections, no intraoperative strokes, and no new-onset acute renal failure requiring dialysis. Two postoperative strokes resolved completely. Two patients experienced nitinol clip fracture and mitral ring dehiscence requiring reoperation. There were 2 early deaths. All patients had regurgitation grades of less than 2 at follow-up (p < 0.001). CONCLUSIONS: Combined robotic mitral-tricuspid valve repair can be performed safely and reproducibly, with acceptable early results. Long-term follow-up will be needed to establish this as an alternative to traditional sternotomy approaches.
BACKGROUND:Robotic mitral valve repair has been successfully performed since the late 1990s, but concomitant robotic tricuspid repair has not yet been widely adopted. We report our first 5 years' experience with concomitant robotic mitral-tricuspid valve repair. METHODS: Records were reviewed for all patients who underwent concomitant robotic mitral-tricuspid valve repair in a single practice. Cardiopulmonary bypass was performed with femoral cannulation, antegrade and retrograde cardioplegia, and aortic cross-clamping by balloon occlusion. Access was through 5 ports. Tricuspid repair techniques included De Vega, modified De Vega with annuloplasty band, and annuloplasty band with interrupted suture repair. RESULTS: From August 2006 to December 2011, 50 patients underwent concomitant robotic mitral-tricuspid valve repair. The mean age was 73.4±9.3 years, and all patients had mitral or tricuspid regurgitation grades of 2+ or greater preoperatively. Cross-clamp and cardiopulmonary bypass times decreased significantly with surgeon experience. There were no conversions to sternotomy and one conversion to mitral valve replacement. Six patients required reexploration for bleeding or hemothorax, most of them early in the series. There were no infections, no intraoperative strokes, and no new-onset acute renal failure requiring dialysis. Two postoperative strokes resolved completely. Two patients experienced nitinol clip fracture and mitral ring dehiscence requiring reoperation. There were 2 early deaths. All patients had regurgitation grades of less than 2 at follow-up (p < 0.001). CONCLUSIONS: Combined robotic mitral-tricuspid valve repair can be performed safely and reproducibly, with acceptable early results. Long-term follow-up will be needed to establish this as an alternative to traditional sternotomy approaches.
Authors: Ahmet Ümit Güllü; Şahin Şenay; Muharrem Koçyiğit; Eyüp Murat Ökten; Mert Dumantepe; Hasan Karabulut; Cem Alhan Journal: Turk Gogus Kalp Damar Cerrahisi Derg Date: 2019-10-23 Impact factor: 0.332
Authors: Eric J Lehr; T Sloane Guy; Robert L Smith; Eugene A Grossi; Richard J Shemin; Evelio Rodriguez; Gorav Ailawadi; Arvind K Agnihotri; Trevor M Fayers; W Clark Hargrove; Brian W Hummel; Junaid H Khan; S Chris Malaisrie; John R Mehall; Douglas A Murphy; William H Ryan; Arash Salemi; Romualdo J Segurola; J Michael Smith; J Alan Wolfe; Paul W Weldner; Glenn R Barnhart; Scott M Goldman; Clifton T P Lewis Journal: Innovations (Phila) Date: 2016 Jul-Aug