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启动二尖瓣修复机器人手术新项目。前九个月的经验教训。

Starting A New Robotic Surgery Program for Mitral Valve Repair. Lessons Learned from The First Nine Months.

作者信息

Piperata Antonio, Busuttil Olivier, d'Ostrevy Nicolas, Jansens Jean-Luc, Taymoor Saud, Cuko Besart, Modine Thomas, Pernot Mathieu, Labrousse Louis

机构信息

Department of Cardiology and Cardio-Vascular Surgery, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital, 33604 Bordeaux, France.

Department of Cardiac Surgery, Erasme Hospital of Brussels, ULB, Belgium free University of Brussels (ULB), Hôpital Erasme, 1070 Brussels, Belgium.

出版信息

J Clin Med. 2021 Nov 21;10(22):5439. doi: 10.3390/jcm10225439.

Abstract

(1) Background: Although transcatheter technology is rapidly growing and represents a promising strategy, the surgical approach remains the best way to repair a degenerative mitral valve regurgitation. In this context, robotic surgery is technologically the most advanced method of minimally invasive mitral valve repair. The aim of this study is to present the preliminary results of the initial single-center experience with a new robotic mitral valve repair program. (2) Methods: We retrospectively reviewed the records of patients who underwent robotic mitral valve repair at our Institution between January and September 2021. (3) Results: A total of 29 patients underwent mitral valve repair with annuloplasty and chordal implantation to treat degenerative mitral regurgitation. The procedure's success was achieved in 97% of patients. The 30-day cardiac-related mortality was 0%. The median CPB and cross-clamp times were 189 and 111 min, respectively, with a progressive reduction from the beginning of the robotic program. (4) Conclusions: Considering all the limitations related to the small sample, the presented results of robotic mitral valve repair appear to be encouraging and acceptable. A careful patient selection, a dedicated team, and a robust experience in surgical mitral valve repair are the fundamentals to start a new robotic mitral surgery program.

摘要

(1) 背景:尽管经导管技术发展迅速且是一种有前景的策略,但手术方法仍是修复退行性二尖瓣反流的最佳方式。在此背景下,机器人手术是技术上最先进的微创二尖瓣修复方法。本研究的目的是展示一项新的机器人二尖瓣修复项目在单一中心的初步经验结果。(2) 方法:我们回顾性分析了2021年1月至9月在我院接受机器人二尖瓣修复手术的患者记录。(3) 结果:共有29例患者接受了二尖瓣修复手术,采用瓣环成形术和弦索植入术治疗退行性二尖瓣反流。97%的患者手术成功。30天心脏相关死亡率为0%。体外循环(CPB)和主动脉阻断时间的中位数分别为189分钟和111分钟,自机器人项目开展以来呈逐渐下降趋势。(4) 结论:考虑到与小样本相关的所有局限性,所展示的机器人二尖瓣修复结果似乎令人鼓舞且可以接受。谨慎的患者选择、专业的团队以及丰富的二尖瓣手术修复经验是启动新的机器人二尖瓣手术项目的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abb2/8674761/2d1ceed015b4/jcm-10-05439-g001.jpg

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