Robotic Mitral Valve Repair: Indication for Surgery Does Not Influence Early Outcomes

Simon Maltais, Lucman A. Anwer, Richard C. Daly, Salvatore Poddi, Yan Topilsky, Maurice Enrique-Sarano, Hector I. Michelena, William J. Mauermann, Joseph A. Dearani

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the outcomes of robotic mitral valve repair (MVr) by primary indication per American Heart Association guidelines for surgery: class I vs class IIa. Patients and Methods: From January 1, 2008, through September 30, 2016, 603 patients underwent robotic MVr for severe primary mitral regurgitation. Medical records of 576 consenting patients were retrospectively reviewed to determine the primary indication for surgery. Patients were stratified into class I or class IIa, and preoperative, intraoperative, and postoperative variables were compared. Results: Of 516 patients, 428 (83%) had class I indication and 88 (17%) had class IIa indication for surgery. Preoperatively, no significant differences were observed between both cohorts. Importantly, a significantly higher number of patients with class I indication underwent MVr for bileaflet prolapse (172 of 428 [40%] vs 21 of 88 [25%]; P=.03). Early MVr outcomes indicated recurrent mitral regurgitation (moderate or greater) in only 12 of 576 (2%), and no significant differences were observed between classes (P=.23). Apart from parameters for ventricular size, all other intraoperative and postoperative variables were comparable between both cohorts. Conclusion: Comparable outcomes were indicated across all classes of indications for MVr surgery. These results continue to support the use of this surgical technique, even in less sick patients. Early referral along with more extensive robotic MVr experience will likely result in further improvements in long-term outcomes.

Original languageEnglish (US)
Pages (from-to)2263-2269
Number of pages7
JournalMayo Clinic proceedings
Volume94
Issue number11
DOIs
StatePublished - Nov 2019

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Robotics
Mitral Valve
Mitral Valve Insufficiency
Prolapse
Medical Records
Referral and Consultation
Guidelines

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Maltais, S., Anwer, L. A., Daly, R. C., Poddi, S., Topilsky, Y., Enrique-Sarano, M., ... Dearani, J. A. (2019). Robotic Mitral Valve Repair: Indication for Surgery Does Not Influence Early Outcomes. Mayo Clinic proceedings, 94(11), 2263-2269. https://doi.org/10.1016/j.mayocp.2019.05.025

Robotic Mitral Valve Repair : Indication for Surgery Does Not Influence Early Outcomes. / Maltais, Simon; Anwer, Lucman A.; Daly, Richard C.; Poddi, Salvatore; Topilsky, Yan; Enrique-Sarano, Maurice; Michelena, Hector I.; Mauermann, William J.; Dearani, Joseph A.

In: Mayo Clinic proceedings, Vol. 94, No. 11, 11.2019, p. 2263-2269.

Research output: Contribution to journalArticle

Maltais, S, Anwer, LA, Daly, RC, Poddi, S, Topilsky, Y, Enrique-Sarano, M, Michelena, HI, Mauermann, WJ & Dearani, JA 2019, 'Robotic Mitral Valve Repair: Indication for Surgery Does Not Influence Early Outcomes', Mayo Clinic proceedings, vol. 94, no. 11, pp. 2263-2269. https://doi.org/10.1016/j.mayocp.2019.05.025
Maltais, Simon ; Anwer, Lucman A. ; Daly, Richard C. ; Poddi, Salvatore ; Topilsky, Yan ; Enrique-Sarano, Maurice ; Michelena, Hector I. ; Mauermann, William J. ; Dearani, Joseph A. / Robotic Mitral Valve Repair : Indication for Surgery Does Not Influence Early Outcomes. In: Mayo Clinic proceedings. 2019 ; Vol. 94, No. 11. pp. 2263-2269.
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