Khaliel Feras H, Al Aboud Mohammed S, Fallatah Faisal A, Alenazy Ali B
Adult Cardiac Surgery Section, Department of Surgery, Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
Adult Echocardiography Section, Department of Cardiology, Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
Ann Cardiothorac Surg. 2025 May 31;14(3):202-209. doi: 10.21037/acs-2024-ravr-0195. Epub 2025 May 29.
Robotic aortic valve replacement (RAVR) has seen a rise in usage in recent years; however, follow-up data remain limited. This study aimed to assess the short- and mid-term clinical outcomes after RAVR.
This study included patients who underwent RAVR between 2022 and 2024. The primary outcomes were mortality and survival at follow-up. The secondary outcomes were hospital complications and echocardiographic parameters at follow-up.
Fifteen patients underwent RAVR. The mean age was 38.6±14.4 years, and 86.7% were males. The median Society of Thoracic Surgery (STS) score was 0.6%. Isolated RAVR was performed in 66.7% of the patients (n=10), whereas five patients underwent concomitant surgery, including mitral valve repair (n=1), mitral valve replacement (n=3), and ascending aortoplasty (n=1). Mechanical valves were used in 10 patients (66.7%). The mean ischemic time was 150±33.9 min. No sternotomy conversion was required. The median length of hospital stay was 9 days [quartile (Q)1-Q3, 4-15 days]. Four patients had on-table extubation (26.7%). One patient required intensive care unit (ICU) readmission, and one patient was readmitted for pleural effusion. The median follow-up was 24 months (Q1-Q3, 15-29 months). No mortality was reported during this period. All patients were in New York Heart Association (NYHA) class I, except for one in NYHA II. There were no significant changes in left ventricular ejection fraction (LEVF) at the last follow-up compared with the preoperative value (P=0.741). However, the left ventricular end-diastolic diameter (LVEDD) was significantly lower at follow-up than preoperatively (P=0.003).
RAVR demonstrates promising short- and mid-term clinical outcomes. Its minimally invasive nature and the ability to use durable mechanical valves may offer potential advantages over traditional surgical and transcatheter approaches.
近年来，机器人辅助主动脉瓣置换术（RAVR）的应用有所增加；然而，随访数据仍然有限。本研究旨在评估RAVR术后的短期和中期临床结果。
本研究纳入了2022年至2024年间接受RAVR的患者。主要结局是随访时的死亡率和生存率。次要结局是随访时的医院并发症和超声心动图参数。
15例患者接受了RAVR。平均年龄为38.6±14.4岁，86.7%为男性。胸外科医师协会（STS）评分中位数为0.6%。66.7%的患者（n=10）进行了单纯RAVR，而5例患者接受了同期手术，包括二尖瓣修复（n=1）、二尖瓣置换（n=3）和升主动脉成形术（n=1）。10例患者（66.7%）使用了机械瓣膜。平均缺血时间为150±33.9分钟。无需转为开胸手术。住院时间中位数为9天[四分位数（Q）1-Q3，4-15天]。4例患者在手术台上拔管（26.7%）。1例患者需要再次入住重症监护病房（ICU），1例患者因胸腔积液再次入院。中位随访时间为24个月（Q1-Q3，15-29个月）。在此期间未报告死亡病例。除1例纽约心脏协会（NYHA）II级患者外，所有患者均为NYHA I级。与术前值相比，末次随访时左心室射血分数（LEVF）无显著变化（P=0.741）。然而，随访时左心室舒张末期内径（LVEDD）明显低于术前（P=0.003）。
RAVR显示出良好的短期和中期临床结果。其微创性质以及使用耐用机械瓣膜的能力可能比传统手术和经导管方法具有潜在优势。
