Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged
Objective Recent reports have shown that robotic mitral valve repair is effective in treating posterior leaflet disease; however, comparison with trans-sternal (open) valvuloplasty for all prolapse categories has not been performed. Moreover, data from the recently published EVEREST II trial infer t...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2011-11, Vol.142 (5), p.970-979 |
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| creator | Suri, Rakesh M., MD, DPhil Burkhart, Harold M., MD Daly, Richard C., MD Dearani, Joseph A., MD Park, Soon J., MD Sundt, Thoralf M., MD Li, Zhuo, MS Enriquez-Sarano, Maurice, MD Schaff, Hartzell V., MD |
| description | Objective Recent reports have shown that robotic mitral valve repair is effective in treating posterior leaflet disease; however, comparison with trans-sternal (open) valvuloplasty for all prolapse categories has not been performed. Moreover, data from the recently published EVEREST II trial infer that adverse event rates after mitral valve repair for degenerative disease are high. We therefore compared early outcomes of robotic versus open mitral valve repair for patients with mitral valve prolapse. Methods Among 745 consecutive patients undergoing open or robotic mitral repair for degenerative disease, 95 propensity-matched pairs were identified. Leaflet prolapse categories were similar between groups. Complete mitral valve repair was performed using identical techniques. Results Median crossclamp and bypass times were longer in the robotic group but decreased significantly over time ( P |
| doi_str_mv | 10.1016/j.jtcvs.2011.07.027 |
| format | Article |
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Moreover, data from the recently published EVEREST II trial infer that adverse event rates after mitral valve repair for degenerative disease are high. We therefore compared early outcomes of robotic versus open mitral valve repair for patients with mitral valve prolapse. Methods Among 745 consecutive patients undergoing open or robotic mitral repair for degenerative disease, 95 propensity-matched pairs were identified. Leaflet prolapse categories were similar between groups. Complete mitral valve repair was performed using identical techniques. Results Median crossclamp and bypass times were longer in the robotic group but decreased significantly over time ( P < .001). There were no conversions to open sternotomy, repair rate and early survival were 100%, dismissal mitral regurgitation grade was similar ( P = 1.00), and all patients in the robotic group had mild or less mitral regurgitation at 1 month after repair. There were no differences in adverse events (5% open vs 4% robotic, P = 1.00). Patients in the robotic group had shorter postoperative ventilation time, intensive care unit stay, and hospital stay. Conclusions Robotic mitral valve repair allows complete anatomic correction of all categories of leaflet prolapse using techniques identical to open approaches. Robotic repair effectively corrects mitral regurgitation, offers excellent freedom from adverse events, and facilitates rapid weaning from ventilation, translating into earlier hospital dismissal. Safety and efficacy after both open and robotic mitral valve repair are higher than recently reported in the EVEREST II trial and establish a benchmark against which nonsurgical therapies should be evaluated.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2011.07.027</identifier><identifier>PMID: 21911231</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Benchmarking ; Biological and medical sciences ; Cardiac Catheterization - standards ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Chi-Square Distribution ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Heart Valve Prosthesis Implantation - adverse effects ; Heart Valve Prosthesis Implantation - standards ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Minnesota ; Mitral Valve Annuloplasty - adverse effects ; Mitral Valve Annuloplasty - standards ; Mitral Valve Insufficiency - etiology ; Mitral Valve Insufficiency - therapy ; Mitral Valve Prolapse - surgery ; Pneumology ; Respiration, Artificial ; Retrospective Studies ; Robotics - standards ; Surgery, Computer-Assisted - adverse effects ; Surgery, Computer-Assisted - standards ; Time Factors ; Treatment Outcome</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2011-11, Vol.142 (5), p.970-979</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2011 The American Association for Thoracic Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-138cbfd962fa4922255555c25d5d83ef9233d918e7d7b8a9fb371365601d46273</citedby><cites>FETCH-LOGICAL-c488t-138cbfd962fa4922255555c25d5d83ef9233d918e7d7b8a9fb371365601d46273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522311007525$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24750446$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21911231$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suri, Rakesh M., MD, DPhil</creatorcontrib><creatorcontrib>Burkhart, Harold M., MD</creatorcontrib><creatorcontrib>Daly, Richard C., MD</creatorcontrib><creatorcontrib>Dearani, Joseph A., MD</creatorcontrib><creatorcontrib>Park, Soon J., MD</creatorcontrib><creatorcontrib>Sundt, Thoralf M., MD</creatorcontrib><creatorcontrib>Li, Zhuo, MS</creatorcontrib><creatorcontrib>Enriquez-Sarano, Maurice, MD</creatorcontrib><creatorcontrib>Schaff, Hartzell V., MD</creatorcontrib><title>Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective Recent reports have shown that robotic mitral valve repair is effective in treating posterior leaflet disease; however, comparison with trans-sternal (open) valvuloplasty for all prolapse categories has not been performed. Moreover, data from the recently published EVEREST II trial infer that adverse event rates after mitral valve repair for degenerative disease are high. We therefore compared early outcomes of robotic versus open mitral valve repair for patients with mitral valve prolapse. Methods Among 745 consecutive patients undergoing open or robotic mitral repair for degenerative disease, 95 propensity-matched pairs were identified. Leaflet prolapse categories were similar between groups. Complete mitral valve repair was performed using identical techniques. Results Median crossclamp and bypass times were longer in the robotic group but decreased significantly over time ( P < .001). There were no conversions to open sternotomy, repair rate and early survival were 100%, dismissal mitral regurgitation grade was similar ( P = 1.00), and all patients in the robotic group had mild or less mitral regurgitation at 1 month after repair. There were no differences in adverse events (5% open vs 4% robotic, P = 1.00). Patients in the robotic group had shorter postoperative ventilation time, intensive care unit stay, and hospital stay. Conclusions Robotic mitral valve repair allows complete anatomic correction of all categories of leaflet prolapse using techniques identical to open approaches. Robotic repair effectively corrects mitral regurgitation, offers excellent freedom from adverse events, and facilitates rapid weaning from ventilation, translating into earlier hospital dismissal. Safety and efficacy after both open and robotic mitral valve repair are higher than recently reported in the EVEREST II trial and establish a benchmark against which nonsurgical therapies should be evaluated.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Benchmarking</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization - standards</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Chi-Square Distribution</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heart Valve Prosthesis Implantation - standards</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minnesota</subject><subject>Mitral Valve Annuloplasty - adverse effects</subject><subject>Mitral Valve Annuloplasty - standards</subject><subject>Mitral Valve Insufficiency - etiology</subject><subject>Mitral Valve Insufficiency - therapy</subject><subject>Mitral Valve Prolapse - surgery</subject><subject>Pneumology</subject><subject>Respiration, Artificial</subject><subject>Retrospective Studies</subject><subject>Robotics - standards</subject><subject>Surgery, Computer-Assisted - adverse effects</subject><subject>Surgery, Computer-Assisted - standards</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkkuLFDEUhQtRnHb0FwiSjbjqNo96CgoyjA8YEHyAu5BKbnWlJl2pyU219G_zz5nqbhXcmE0253zce87NsqeMbhhl5cthM0S9xw2njG1otaG8upetGG2qdVkX3-9nK0o5Xxeci4vsEeJAKa0oax5mF5w1jHHBVtnPz7710WqyszEoR_bK7YEEmJQNpPOBKOfIFLxTEwLBuUWISGa045ZE0P1o72ZAYg2MiZIA0RM_wXgEzc5PTmE8vCLXGFXrLPZHYw-khVH3OxVuidoqO2IkP3qrezJB0HNUI_g5YccIYb-g_YgEez87k5xkmM0WzOPsQaccwpPzf5l9e3f99erD-ubT-49Xb2_WOq_ruGai1m1nmpJ3Km8458XyNC9MYWoBXcOFMA2roTJVW6uma0XFRFmUlJm85JW4zF6cuCmHZdsodxY1OHeaUjaUloIJ2iSlOCl18IgBOjkFm5Y8SEblUpoc5LE0uZQmaSXpkf_szJ_bHZg_nt8tJcHzs0BhyrgLatQW_-ryqqB5Xibd65MOUhp7C0GitilnMDaAjtJ4-59B3vzj186OS623cAAc_BzGFLRkErmk8styX8t5MZYuq-CF-AUqHNBz</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Suri, Rakesh M., MD, DPhil</creator><creator>Burkhart, Harold M., MD</creator><creator>Daly, Richard C., MD</creator><creator>Dearani, Joseph A., MD</creator><creator>Park, Soon J., MD</creator><creator>Sundt, Thoralf M., MD</creator><creator>Li, Zhuo, MS</creator><creator>Enriquez-Sarano, Maurice, MD</creator><creator>Schaff, Hartzell V., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111101</creationdate><title>Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged</title><author>Suri, Rakesh M., MD, DPhil ; Burkhart, Harold M., MD ; Daly, Richard C., MD ; Dearani, Joseph A., MD ; Park, Soon J., MD ; Sundt, Thoralf M., MD ; Li, Zhuo, MS ; Enriquez-Sarano, Maurice, MD ; Schaff, Hartzell V., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-138cbfd962fa4922255555c25d5d83ef9233d918e7d7b8a9fb371365601d46273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Benchmarking</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization - standards</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Chi-Square Distribution</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Heart Valve Prosthesis Implantation - standards</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minnesota</topic><topic>Mitral Valve Annuloplasty - adverse effects</topic><topic>Mitral Valve Annuloplasty - standards</topic><topic>Mitral Valve Insufficiency - etiology</topic><topic>Mitral Valve Insufficiency - therapy</topic><topic>Mitral Valve Prolapse - surgery</topic><topic>Pneumology</topic><topic>Respiration, Artificial</topic><topic>Retrospective Studies</topic><topic>Robotics - standards</topic><topic>Surgery, Computer-Assisted - adverse effects</topic><topic>Surgery, Computer-Assisted - standards</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suri, Rakesh M., MD, DPhil</creatorcontrib><creatorcontrib>Burkhart, Harold M., MD</creatorcontrib><creatorcontrib>Daly, Richard C., MD</creatorcontrib><creatorcontrib>Dearani, Joseph A., MD</creatorcontrib><creatorcontrib>Park, Soon J., MD</creatorcontrib><creatorcontrib>Sundt, Thoralf M., MD</creatorcontrib><creatorcontrib>Li, Zhuo, MS</creatorcontrib><creatorcontrib>Enriquez-Sarano, Maurice, MD</creatorcontrib><creatorcontrib>Schaff, Hartzell V., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suri, Rakesh M., MD, DPhil</au><au>Burkhart, Harold M., MD</au><au>Daly, Richard C., MD</au><au>Dearani, Joseph A., MD</au><au>Park, Soon J., MD</au><au>Sundt, Thoralf M., MD</au><au>Li, Zhuo, MS</au><au>Enriquez-Sarano, Maurice, MD</au><au>Schaff, Hartzell V., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>142</volume><issue>5</issue><spage>970</spage><epage>979</epage><pages>970-979</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objective Recent reports have shown that robotic mitral valve repair is effective in treating posterior leaflet disease; however, comparison with trans-sternal (open) valvuloplasty for all prolapse categories has not been performed. Moreover, data from the recently published EVEREST II trial infer that adverse event rates after mitral valve repair for degenerative disease are high. We therefore compared early outcomes of robotic versus open mitral valve repair for patients with mitral valve prolapse. Methods Among 745 consecutive patients undergoing open or robotic mitral repair for degenerative disease, 95 propensity-matched pairs were identified. Leaflet prolapse categories were similar between groups. Complete mitral valve repair was performed using identical techniques. Results Median crossclamp and bypass times were longer in the robotic group but decreased significantly over time ( P < .001). There were no conversions to open sternotomy, repair rate and early survival were 100%, dismissal mitral regurgitation grade was similar ( P = 1.00), and all patients in the robotic group had mild or less mitral regurgitation at 1 month after repair. There were no differences in adverse events (5% open vs 4% robotic, P = 1.00). Patients in the robotic group had shorter postoperative ventilation time, intensive care unit stay, and hospital stay. Conclusions Robotic mitral valve repair allows complete anatomic correction of all categories of leaflet prolapse using techniques identical to open approaches. Robotic repair effectively corrects mitral regurgitation, offers excellent freedom from adverse events, and facilitates rapid weaning from ventilation, translating into earlier hospital dismissal. Safety and efficacy after both open and robotic mitral valve repair are higher than recently reported in the EVEREST II trial and establish a benchmark against which nonsurgical therapies should be evaluated.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>21911231</pmid><doi>10.1016/j.jtcvs.2011.07.027</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Benchmarking Biological and medical sciences Cardiac Catheterization - standards Cardiology. Vascular system Cardiothoracic Surgery Chi-Square Distribution Endocardial and cardiac valvular diseases Female Heart Heart Valve Prosthesis Implantation - adverse effects Heart Valve Prosthesis Implantation - standards Humans Intensive Care Units Length of Stay Male Medical sciences Middle Aged Minnesota Mitral Valve Annuloplasty - adverse effects Mitral Valve Annuloplasty - standards Mitral Valve Insufficiency - etiology Mitral Valve Insufficiency - therapy Mitral Valve Prolapse - surgery Pneumology Respiration, Artificial Retrospective Studies Robotics - standards Surgery, Computer-Assisted - adverse effects Surgery, Computer-Assisted - standards Time Factors Treatment Outcome |
| title | Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged |
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