Wei Ling-Yi, Chen Jen-Wei, Chou Nai-Kwan, Wang Yi-Chia, Huang Chi-Hsiang, Yu His-Yu, Chi Nai-Hsin
Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Ann Cardiothorac Surg. 2025 May 31;14(3):210-217. doi: 10.21037/acs-2024-ravr-0185. Epub 2025 May 28.
Minimally invasive approaches in cardiac surgery have transformed the field by reducing surgical trauma and improving recovery outcomes. The lateral approach, using robotic and endoscopic technologies, offers superior visualization for complex procedures, such as combined aortic and mitral valve surgery. Addressing concurrent pathologies in the aortic and mitral valves increases procedural complexity, requiring precise techniques and optimal patient selection.
This retrospective, single-center study evaluated adult patients who underwent robotic or endoscopic combined aortic and mitral valve surgery between January 2015 and November 2024. Data on patient demographics, perioperative details, and postoperative outcomes including complications, mortality rates, and improvements in New York Heart Association (NYHA) functional status were analyzed.
A total of 67 patients were included, with 8 undergoing robotic and 59 endoscopic procedures. No mortality or conversion to open surgery was observed. Postoperative complications were minimal, with a low infection rate of 1.5% and an atrial fibrillation rate of 26.8%. Over 85% of patients experienced significant improvement in NYHA functional status.
Robotic and endoscopic combined aortic and mitral valve surgery using the lateral approach is safe and effective, yielding excellent outcomes in a well-selected patient population.
心脏手术中的微创方法通过减少手术创伤和改善恢复结果改变了该领域。采用机器人和内镜技术的外侧入路为复杂手术（如主动脉瓣和二尖瓣联合手术）提供了更好的视野。处理主动脉瓣和二尖瓣的并发病变会增加手术复杂性，需要精确的技术和最佳的患者选择。
这项回顾性单中心研究评估了2015年1月至2024年11月期间接受机器人或内镜下主动脉瓣和二尖瓣联合手术的成年患者。分析了患者人口统计学、围手术期细节以及术后结果的数据，包括并发症、死亡率和纽约心脏协会（NYHA）功能状态的改善情况。
共纳入67例患者，其中8例接受机器人手术，59例接受内镜手术。未观察到死亡或转为开放手术的情况。术后并发症极少，感染率低至1.5%，房颤发生率为26.8%。超过85%的患者NYHA功能状态有显著改善。
采用外侧入路的机器人和内镜下主动脉瓣和二尖瓣联合手术安全有效，在精心选择的患者群体中产生了优异的结果。
