Impact of Valve Repair on Mild Tricuspid Insufficiency in Rheumatic Mitral Surgery

Background Computer enabled robotic mitral valve repair cases have longer cross-clamp and perfusion times because of the more technically difficult procedure. To modify some of the well-documented side effects of standard cardiopulmonary bypass (CPB), we used a new mini-circuit on three robotic mitral cases. Methods Three patients having mitral valve repair (triangular resection of P2 and annuloplasty ring) using the daVinci Robot (Intuitive Surgical, Sunnyvale, CA) had circulatory support using a modified Resting Heart System (Medtronic, Inc., Fridley, MN), a vertically oriented space saving CPB configuration incorporating a high efficiency miniaturized oxygenator, centrifugal pump, shortened heparin coated tubing and an air evacuation system with a closed circuit. Results All patients had successful mitral repair (echo = 0 to trace residual leakage) under a cross-clamp time of 161 ± 54 minutes and perfusion time of 229 ± 31 minutes. No blood was given during CPB and 0.7 ± 1.2 red cell units after the CPB run and 0.7 ± 1.2 units during the postoperative course. Conclusion Miniaturized bypass circuit reducing the level of necessary anticoagulation, hemodilation, and blood trauma can be used despite the increased perfusion time necessary for robotic mitral surgery.

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A simple technique of artificial chordae implantation in robotic cardiac surgery using a novel tube device supporting expanded polytetrafluoroethylene chordae ligation

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa408 ◽

2020 ◽

Author(s):

Takeo Tedoriya ◽

Ryoi Okano ◽

Masaomi Fukuzumi ◽

Tadamasa Miyauchi

Keyword(s):

Mitral Valve ◽

Mitral Valve Repair ◽

Simple Technique ◽

Valve Repair ◽

Expanded Polytetrafluoroethylene ◽

Novel Device ◽

Robotic Cardiac Surgery ◽

Artificial Chordae ◽

The Right ◽

Mitral Surgery

Abstract Artificial chordae implantation is an important technique for treating leaflet lesions in mitral valve repair. Considering that the expanded polytetrafluoroethylene (ePTFE) suture is slippery on the surface, adequate ligation without laxity should be critically considered, especially in robotic surgery. To resolve this issue, we applied a novel device that controls the length of an ePTFE suture (Chordarizer) for artificial chordae implantation in robotic mitral valve repair. After assessing the mitral valve via the right side of the left atrium, we stitched a CV-4 ePTFE suture to the target papillary muscle. Using a calliper, we measured the length of the artificial chordae and passed the CV-4 through the appropriate Chordarizer. Then, we stitched the CV-4 to the tip of the leaflet from the left ventricle side and tied it using da Vinci arms. Finally, the Chordarizer was peeled away. Chordarizer ensured safe and reliable artificial chordae implantation procedures with robotic mitral surgery, by maintaining the desired CV4 length.

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De Vega annuloplasty for tricuspid valve repair in posttraumatic tricuspid insufficiency — 16 years experience

International Journal of Cardiology ◽

10.1016/j.ijcard.2007.01.027 ◽

2008 ◽

Vol 126 (3) ◽

pp. e61-e62 ◽

Cited By ~ 5

Author(s):

Christoph Bara ◽

Ruoyu Zhang ◽

Axel Haverich

Keyword(s):

Tricuspid Valve ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Tricuspid Insufficiency

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Long-term outcomes of tricuspid valve repair for functional tricuspid insufficiency

Kardiologiya i serdechno-sosudistaya khirurgiya ◽

10.17116/kardio202114051343 ◽

2021 ◽

Vol 14 (5) ◽

pp. 343

Author(s):

A.E. Kaipov ◽

M.N. Mukharyamov ◽

I.I. Vagizov ◽

R.N. Khairullin ◽

R.K. Dzhordzhikiya

Keyword(s):

Tricuspid Valve ◽

Tricuspid Valve Repair ◽

Valve Repair ◽

Long Term Outcomes ◽

Tricuspid Insufficiency

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

Journal of Clinical Medicine ◽

10.3390/jcm10225439 ◽

2021 ◽

Vol 10 (22) ◽

pp. 5439

Author(s):

Antonio Piperata ◽

Olivier Busuttil ◽

Nicolas d’Ostrevy ◽

Jean-Luc Jansens ◽

Saud Taymoor ◽

...

Keyword(s):

Robotic Surgery ◽

Mitral Valve ◽

Mitral Valve Repair ◽

Mitral Valve Regurgitation ◽

Small Sample ◽

Lessons Learned ◽

Valve Repair ◽

Single Center Experience ◽

Dedicated Team ◽

Mitral Surgery

(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.

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