Liu Guopeng, Zhang Huajun, Yang Ming, Wang Rong, Xiao Cangsong, Wang Gang, Wang Yao, Gao Changqing
Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China.
Department of Cardiovascular Surgery, Institute of Cardiac Surgery, PLA General Hospital, Beijing, China -
J Cardiovasc Surg (Torino). 2019 Jun;60(3):406-412. doi: 10.23736/S0021-9509.19.10602-7. Epub 2019 Jan 28.
The feasibility and safety of robotic mitral valve repair has been proven in several studies but the mid-term to long-term outcomes are unclear. We aim to summarize our surgical experience with robotic mitral valve repair and demonstrate the follow-up results out to 7 years.
From 2007 to 2014, 110 consecutive patients underwent robotic mitral valve repair with da Vinci Surgical System (Intuitive Surgical, USA) in our center. The operative data were collected, and patients were echocardiographically followed regularly up to 7 years.
The patients' average age was 45±13 (14 to 70) years with male to female ratio of 2.3:1. Mitral regurgitation (95.5%) or stenosis (4.5%) was diagnosed. The triangular or quadrangular resection was the most performed type of repair (63.3%). Nitinol U-clips (58.1%), running suture (31.1%), and Cor-Knot™ suture device (LSI Solutions, Victor, NY) (10.8%) were used to secure the annuloplasty ring. All cases were performed by the same surgeon. One case of conversion to sternotomy was noted. The mean CPB time was 121±34.3 (range, 70 to 152) minutes, and the mean cross-clamp time was 82.6±25.3 (range, 47 to 122) minutes. After surgery, one death (0.91%) and two cases of transient neurocognitive defect (1.82%) occurred. Three cases of early failure of repair that required reoperation (2.73%) were noticed. All patients were successfully followed for a median of 4.1 (range, 1 month to 7 years) years and 94.5% had freedom of re-operation.
Robotic mitral valve repair is a safe and effective procedure with excellent mid-term outcomes.
多项研究已证实机器人二尖瓣修复术的可行性和安全性，但中期至长期结果尚不清楚。我们旨在总结我们机器人二尖瓣修复术的手术经验，并展示长达7年的随访结果。
2007年至2014年，我们中心连续110例患者使用达芬奇手术系统（美国直观外科公司）接受机器人二尖瓣修复术。收集手术数据，并对患者进行超声心动图定期随访，最长达7年。
患者平均年龄为45±13（14至70）岁，男女比例为2.3:1。诊断为二尖瓣反流（95.5%）或狭窄（4.5%）。三角形或四边形切除是最常进行的修复类型（63.3%）。使用镍钛合金U形夹（58.1%）、连续缝合（31.1%）和Cor-Knot™缝合装置（LSI Solutions，纽约州维克托）（10.8%）固定瓣环成形环。所有病例均由同一位外科医生进行。记录到1例转为胸骨切开术的病例。平均体外循环时间为121±34.3（范围70至152）分钟，平均主动脉阻断时间为82.6±25.3（范围47至122）分钟。术后发生1例死亡（0.91%）和2例短暂性神经认知缺陷（1.82%）。注意到3例早期修复失败需要再次手术（2.73%）。所有患者均成功随访，中位随访时间为4.1（范围1个月至7年）年，94.5%的患者无需再次手术。
机器人二尖瓣修复术是一种安全有效的手术，中期效果良好。
