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

65 Scopus citations

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 1 2012

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Keywords

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

ASJC Scopus subject areas

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

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