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机器人二尖瓣修复术:7 年单中心经验。

Robotic mitral valve repair: A single center experience over a 7-year period.

机构信息

Cardiovascular Research Center, Institute for Experimental and Clinical Research, Catholic University of Louvain, Brussels, Belgium.

Department of Cardiovascular and Thoracic Surgery, Saint-Luc University Clinics, Catholic University of Louvain, Brussels, Belgium.

出版信息

J Card Surg. 2022 Aug;37(8):2266-2277. doi: 10.1111/jocs.16575. Epub 2022 May 5.

Abstract

BACKGROUND

We report the clinical and echocardiographic results of our experience in robotic mitral valve repair over a 7-year period. The outcomes of the earliest and the latest patients will be compared.

METHODS

Between March 2012 and October 2019, 226 patients underwent robotic mitral valve repair for severe mitral regurgitation in a single institution. The first 113 patients (Group 1) were operated between March 2012 and September 2015 and the last 113 patients (Group 2) between October 2015 and October 2019. Conventional techniques employed in open surgery were used. Clinical and echographic follow-up were 96.0% and 94.2% complete, respectively.

RESULTS

Successful mitral repair was achieved in all cases with no hospital mortality. The overall survival rate was 92.7 ± 2.8% and 91.0 ± 3.2% at 3 and 7 years, respectively, with no in between groups difference (p = 0.513). The overall freedom from mitral reoperation was 97.4 ± 1.2% at 3 and 7 years and was similar in both groups (p = 0.276). Freedom from mitral regurgitation Grade 2+ at 3 and 7 years were 89.1 ± 2.6% and 87.9 ± 2.8%, respectively, with no significant difference between groups (p = 0.056).

CONCLUSIONS

Developing a robotic mitral repair program can be done without compromising the safety and efficacy of repair. After a well-conducted training, robotic approach allows to perform simple and complex mitral repair using similar techniques as in conventional approach and without additional risk for the patient.

摘要

背景

我们报告了在过去 7 年中机器人二尖瓣修复的临床和超声心动图结果。将比较最早和最晚的患者的结果。

方法

在 2012 年 3 月至 2019 年 10 月期间,226 例严重二尖瓣反流患者在一家医院接受了机器人二尖瓣修复手术。前 113 例患者(组 1)于 2012 年 3 月至 2015 年 9 月进行手术,后 113 例患者(组 2)于 2015 年 10 月至 2019 年 10 月进行手术。采用了传统的开胸手术技术。临床和超声心动图随访分别完成了 96.0%和 94.2%。

结果

所有病例均成功修复二尖瓣,无院内死亡。总体生存率分别为 92.7 ± 2.8%和 91.0 ± 3.2%,3 年和 7 年,两组间无差异(p = 0.513)。二尖瓣再手术的总体无复发率分别为 97.4 ± 1.2%和 97.4 ± 1.2%,两组间无差异(p = 0.276)。二尖瓣反流 2+级的 3 年和 7 年无复发率分别为 89.1 ± 2.6%和 87.9 ± 2.8%,两组间无显著差异(p = 0.056)。

结论

开展机器人二尖瓣修复项目不会影响修复的安全性和疗效。经过良好的培训,机器人方法可以使用与传统方法类似的技术进行简单和复杂的二尖瓣修复,并且不会给患者带来额外的风险。

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