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Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous.

Published byJosé María Salvador Espejo Modified over 5 years ago

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Presentation on theme: "Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous."— Presentation transcript:

1 Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged  Rakesh M. Suri, MD, DPhil, Harold M. Burkhart, MD, Richard C. Daly, MD, Joseph A. Dearani, MD, Soon J. Park, MD, Thoralf M. Sundt, MD, Zhuo Li, MS, Maurice Enriquez-Sarano, MD, Hartzell V. Schaff, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 142, Issue 5, Pages (November 2011) DOI: /j.jtcvs Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Standard Mayo Clinic mitral valve repair techniques using robotic instrumentation. A, The extent of posterior leaflet prolapse is determined and a triangular-shaped resection performed to eliminate redundancy predominating at the leading edge, restoring the position of the coapting margin to the annular plane and decreasing leaflet height. B, The remaining leaflet edges are reapposed using a 2-layer Prolene stitch, restoring normal leaflet coaptation. C, After posterior leaflet correction, a standard-length 63-mm flexible posterior annuloplasty band is inserted using interrupted Ethibond sutures from right to left fibrous trigones. D, Anterior leaflet prolapse is corrected by placing two 5-0 Gore-Tex (WL Gore & Associates, Inc, Flagstaff, Ariz) neochords between the subtending papillary muscle to the unsupported leaflet edge using a double-armed Gore-Tex pledget-backed mattress stitch. E, After anterior leaflet correction, a 63-mm flexible posterior annuloplasty band is inserted using interrupted Ethibond sutures from right to left fibrous trigones. F, Bileaflet repair is performed using a combination of posterior leaflet resection/reconstruction, anterior leaflet neochord resuspension, and standard-length 63-mm flexible posterior annuloplasty band. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Comparison of operative and early postoperative metrics. (A) Cardiopulmonary bypass and (B) ischemic times were longer for the robotic group overall (P < .001), and both decreased steadily and significantly with time (P < .001). (C) Postoperative duration of ventilation, (D) intensive care unit (ICU) stay, and (E) hospital stay were all shorter in the robotic group (P < .001), also decreasing significantly with time (P < .001). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

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