Agnino Alfonso, Graniero Ascanio, Albano Giovanni, Gerometta Pier Silvio, Roscitano Claudio, Villari Nicola, Albertini Andrea, Salvi Daniela, Persico Isabel, Anselmi Amedeo
U.O. Cardiochirurgia Robotica e Mini-Invasiva, Cliniche Humanitas Gavazzeni, Bergamo ²U.O. Anestesia e Terapia Intensiva, Cliniche Humanitas Gavazzeni, Bergamo.
U.O. Anestesia e Terapia Intensiva, Cliniche Humanitas Gavazzeni, Bergamo.
G Ital Cardiol (Rome). 2021 Aug;22(8):648-656. doi: 10.1714/3641.36221.
Mitral valve therapy is rapidly evolving. In this context, there is a clear evolution towards the diffusion of minimally invasive techniques for surgical mitral valve replacement or repair, namely in the context of primary mitral regurgitation. The robotic-assisted mitral surgery strategy allows the greatest reduction in surgical trauma to the patients, as well as improved ergonomics and video-assistance for performance of the mitral procedure. We currently observe a rapid diffusion of robotic-assisted mitral valve surgery across Europe, which rightfully forms part of the treatment modalities available to multidisciplinary Mitral Teams. However, the development of a robotic cardiac surgery program should be established maintaining reproducibility and patient safety. Adequate training and preparation are essential to initiate and sustain a robotic-assisted mitral valve surgery program. Herein, we address its main steps: fundamentals, multidisciplinary approach, risk management, team management, development and consolidation. We also present the initial clinical results in our Center, and analyze some learning-curve aspects.
二尖瓣治疗正在迅速发展。在此背景下，对于外科二尖瓣置换或修复的微创技术，尤其是在原发性二尖瓣反流的情况下，其应用有明显的发展趋势。机器人辅助二尖瓣手术策略能最大程度减少患者的手术创伤，同时改善二尖瓣手术操作的人体工程学和视频辅助效果。目前我们观察到机器人辅助二尖瓣手术在欧洲迅速普及，这理所当然地成为多学科二尖瓣治疗团队可用的治疗方式之一。然而，建立机器人心脏手术项目时应确保可重复性和患者安全。充分的培训和准备对于启动和维持机器人辅助二尖瓣手术项目至关重要。在此，我们阐述其主要步骤：基础、多学科方法、风险管理、团队管理、发展与巩固。我们还展示了我们中心的初步临床结果，并分析了一些学习曲线方面的情况。
