Cardiac Surgeon and Surgical Director, TAVR, Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
Cleve Clin J Med. 2017 Dec;84(12 Suppl 4):e25-e27. doi: 10.3949/ccjm.84.s4.06.
To improve outcomes with robotically assisted mitral valve surgery, Cleveland Clinic conducted a study evaluating outcomes in 1,000 consecutive cases. Primary areas of interest were to determine whether increased surgical experience with robotic techniques improved outcomes and to identify opportunities that could improve procedural processes. Results showed that these surgeries were effective and safe in terms of improvements in procedure time, transfusion rates, stroke risk, number of mitral valve replacements, and number of conversions to sternotomy. The development and implementation of a patient-selection algorithm halfway through the study further improved outcomes by refining patient eligibility criteria. This study showed that use of a focused preoperative assessment with an algorithm-driven patient selection process combined with increased technical expertise can enhance outcomes with robotic mitral valve surgery.
为了改善机器人辅助二尖瓣手术的结果,克利夫兰诊所进行了一项研究,评估了 1000 例连续病例的结果。主要研究领域是确定机器人技术的手术经验增加是否能改善结果,并确定可以改善手术流程的机会。结果表明,就手术时间、输血率、中风风险、二尖瓣置换数量和转为胸骨切开术的数量等方面而言,这些手术在效果和安全性方面都是有效的。在研究进行到一半时开发并实施了患者选择算法,进一步通过细化患者入选标准来改善结果。这项研究表明,使用术前重点评估和基于算法的患者选择流程,并结合增加技术专业知识,可以提高机器人二尖瓣手术的结果。