Quality of life after early mitral valve repair using conventional and robotic approaches

Rakesh M. Suri, Ryan M. Antiel, Harold M. Burkhart, Marianne Huebner, Zhuo Li, David T Eton, Tali Topilsky, Maurice E Sarano, Hartzell V Schaff

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Early mitral valve (MV) repair of degenerative mitral regurgitation is associated with superior clinical outcomes compared with prosthetic replacement and restores normal life expectancy, even in those without symptoms. Although current guidelines recommend prompt referral for effective MV repair in those with severe mitral regurgitation, some are reluctant to pursue early correction due to the perception that short-term quality of life (QOL) may be adversely affected by the operation. Methods: Between January 2008 and November 2009, 202 patients underwent conventional transsternotomy or minimally invasive port-access robot-assisted MV repair, with or without patent foramen ovale closure or left Maze, and were mailed a postsurgical QOL survey. Results: Unadjusted QOL scores for patients undergoing MV repair were excellent early after the operation using both approaches. Robotic repair was associated with slightly improved scores on the Duke Activity Status Index, the Short Form-12 Item Health Survey Physical domain, and the Linear Analogue Self-Assessment frequency of chest pain and fatigue indices during the first postoperative year; however, differences between treatment groups became indistinguishable after 1 year. Robotic repair patients returned to work slightly quicker (median, 33 vs 54 days, p < 0.001). Conclusions: Functional QOL outcomes within the first 2 years after early MV repair are excellent using open and robotic platforms. A robotic approach may be associated with slightly improved early QOL and return to employment-based activities. These results may have implications regarding future evolution of clinical guidelines and economic health care policy.

Original languageEnglish (US)
Pages (from-to)761-769
Number of pages9
JournalAnnals of Thoracic Surgery
Volume93
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Robotics
Mitral Valve
Quality of Life
Mitral Valve Insufficiency
Guidelines
Patent Foramen Ovale
Health Policy
Life Expectancy
Health Surveys
Chest Pain
Fatigue
Referral and Consultation
Economics
Delivery of Health Care

Keywords

  • BMI
  • body mass index
  • CI
  • confidence interval
  • DASI
  • Duke Activity Status Index
  • hazard ratio
  • HR
  • LASA
  • left ventricular
  • linear analogue self-assessment
  • LV
  • MCS
  • mental component summary score
  • mitral regurgitation
  • mitral valve
  • MR
  • MV
  • PCS
  • physical component summary score
  • QOL
  • quality of life
  • SF-12
  • Short Form 12-Item Health Survey

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Quality of life after early mitral valve repair using conventional and robotic approaches. / Suri, Rakesh M.; Antiel, Ryan M.; Burkhart, Harold M.; Huebner, Marianne; Li, Zhuo; Eton, David T; Topilsky, Tali; Sarano, Maurice E; Schaff, Hartzell V.

In: Annals of Thoracic Surgery, Vol. 93, No. 3, 03.2012, p. 761-769.

Research output: Contribution to journalArticle

Suri, Rakesh M. ; Antiel, Ryan M. ; Burkhart, Harold M. ; Huebner, Marianne ; Li, Zhuo ; Eton, David T ; Topilsky, Tali ; Sarano, Maurice E ; Schaff, Hartzell V. / Quality of life after early mitral valve repair using conventional and robotic approaches. In: Annals of Thoracic Surgery. 2012 ; Vol. 93, No. 3. pp. 761-769.
@article{942412b6498d490cb4b60fe999bd3a9c,
title = "Quality of life after early mitral valve repair using conventional and robotic approaches",
abstract = "Background: Early mitral valve (MV) repair of degenerative mitral regurgitation is associated with superior clinical outcomes compared with prosthetic replacement and restores normal life expectancy, even in those without symptoms. Although current guidelines recommend prompt referral for effective MV repair in those with severe mitral regurgitation, some are reluctant to pursue early correction due to the perception that short-term quality of life (QOL) may be adversely affected by the operation. Methods: Between January 2008 and November 2009, 202 patients underwent conventional transsternotomy or minimally invasive port-access robot-assisted MV repair, with or without patent foramen ovale closure or left Maze, and were mailed a postsurgical QOL survey. Results: Unadjusted QOL scores for patients undergoing MV repair were excellent early after the operation using both approaches. Robotic repair was associated with slightly improved scores on the Duke Activity Status Index, the Short Form-12 Item Health Survey Physical domain, and the Linear Analogue Self-Assessment frequency of chest pain and fatigue indices during the first postoperative year; however, differences between treatment groups became indistinguishable after 1 year. Robotic repair patients returned to work slightly quicker (median, 33 vs 54 days, p < 0.001). Conclusions: Functional QOL outcomes within the first 2 years after early MV repair are excellent using open and robotic platforms. A robotic approach may be associated with slightly improved early QOL and return to employment-based activities. These results may have implications regarding future evolution of clinical guidelines and economic health care policy.",
keywords = "BMI, body mass index, CI, confidence interval, DASI, Duke Activity Status Index, hazard ratio, HR, LASA, left ventricular, linear analogue self-assessment, LV, MCS, mental component summary score, mitral regurgitation, mitral valve, MR, MV, PCS, physical component summary score, QOL, quality of life, SF-12, Short Form 12-Item Health Survey",
author = "Suri, {Rakesh M.} and Antiel, {Ryan M.} and Burkhart, {Harold M.} and Marianne Huebner and Zhuo Li and Eton, {David T} and Tali Topilsky and Sarano, {Maurice E} and Schaff, {Hartzell V}",
year = "2012",
month = "3",
doi = "10.1016/j.athoracsur.2011.11.062",
language = "English (US)",
volume = "93",
pages = "761--769",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Quality of life after early mitral valve repair using conventional and robotic approaches

AU - Suri, Rakesh M.

AU - Antiel, Ryan M.

AU - Burkhart, Harold M.

AU - Huebner, Marianne

AU - Li, Zhuo

AU - Eton, David T

AU - Topilsky, Tali

AU - Sarano, Maurice E

AU - Schaff, Hartzell V

PY - 2012/3

Y1 - 2012/3

N2 - Background: Early mitral valve (MV) repair of degenerative mitral regurgitation is associated with superior clinical outcomes compared with prosthetic replacement and restores normal life expectancy, even in those without symptoms. Although current guidelines recommend prompt referral for effective MV repair in those with severe mitral regurgitation, some are reluctant to pursue early correction due to the perception that short-term quality of life (QOL) may be adversely affected by the operation. Methods: Between January 2008 and November 2009, 202 patients underwent conventional transsternotomy or minimally invasive port-access robot-assisted MV repair, with or without patent foramen ovale closure or left Maze, and were mailed a postsurgical QOL survey. Results: Unadjusted QOL scores for patients undergoing MV repair were excellent early after the operation using both approaches. Robotic repair was associated with slightly improved scores on the Duke Activity Status Index, the Short Form-12 Item Health Survey Physical domain, and the Linear Analogue Self-Assessment frequency of chest pain and fatigue indices during the first postoperative year; however, differences between treatment groups became indistinguishable after 1 year. Robotic repair patients returned to work slightly quicker (median, 33 vs 54 days, p < 0.001). Conclusions: Functional QOL outcomes within the first 2 years after early MV repair are excellent using open and robotic platforms. A robotic approach may be associated with slightly improved early QOL and return to employment-based activities. These results may have implications regarding future evolution of clinical guidelines and economic health care policy.

AB - Background: Early mitral valve (MV) repair of degenerative mitral regurgitation is associated with superior clinical outcomes compared with prosthetic replacement and restores normal life expectancy, even in those without symptoms. Although current guidelines recommend prompt referral for effective MV repair in those with severe mitral regurgitation, some are reluctant to pursue early correction due to the perception that short-term quality of life (QOL) may be adversely affected by the operation. Methods: Between January 2008 and November 2009, 202 patients underwent conventional transsternotomy or minimally invasive port-access robot-assisted MV repair, with or without patent foramen ovale closure or left Maze, and were mailed a postsurgical QOL survey. Results: Unadjusted QOL scores for patients undergoing MV repair were excellent early after the operation using both approaches. Robotic repair was associated with slightly improved scores on the Duke Activity Status Index, the Short Form-12 Item Health Survey Physical domain, and the Linear Analogue Self-Assessment frequency of chest pain and fatigue indices during the first postoperative year; however, differences between treatment groups became indistinguishable after 1 year. Robotic repair patients returned to work slightly quicker (median, 33 vs 54 days, p < 0.001). Conclusions: Functional QOL outcomes within the first 2 years after early MV repair are excellent using open and robotic platforms. A robotic approach may be associated with slightly improved early QOL and return to employment-based activities. These results may have implications regarding future evolution of clinical guidelines and economic health care policy.

KW - BMI

KW - body mass index

KW - CI

KW - confidence interval

KW - DASI

KW - Duke Activity Status Index

KW - hazard ratio

KW - HR

KW - LASA

KW - left ventricular

KW - linear analogue self-assessment

KW - LV

KW - MCS

KW - mental component summary score

KW - mitral regurgitation

KW - mitral valve

KW - MR

KW - MV

KW - PCS

KW - physical component summary score

KW - QOL

KW - quality of life

KW - SF-12

KW - Short Form 12-Item Health Survey

UR - http://www.scopus.com/inward/record.url?scp=84863230614&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863230614&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2011.11.062

DO - 10.1016/j.athoracsur.2011.11.062

M3 - Article

C2 - 22364970

AN - SCOPUS:84863230614

VL - 93

SP - 761

EP - 769

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -