Interv Akut Kardiol. 2023;22(1):17-26 | DOI: 10.36290/kar.2023.003

Minimally invasive and robotic mitral valve surgery

Štěpán Černý

Kardiochirurgické oddělení, Nemocnice Na Homolce, Praha

Surgical treatment for mitral regurgitation has undergone dramatic development in the last four decades. To preserve the patient's native valve and restore its proper function with conserving surgery is currently a clear priority in the surgical setting. This procedure is typically referred to as mitral valve repair. Currently, less invasive surgical approaches to the mitral valve are increasingly used that offer patients, in addition to being less invasive, stability and predictability of classic surgical repair based on the principles of modern mitral valve surgery. Video-assisted right-sided mini-thoracotomy or robotic surgery are the most commonly used approaches. In large patient cohorts, these approaches had similar surgical outcomes in terms of valve repairability and displayed lower rates of early complications, lower rates of postoperative atrial fibrillation, lower blood product utilization, shorter duration of mechanical ventilation, shorter intensive care unit stay, and shorter overall duration of hospital stay. Subsequently, a rapid return to normal activities is possible. This is attractive for young patients, particularly in the light of the new guidelines of professional societies wherein the indications for conserving surgery shift to groups of asymptomatic patients and the procedures are preventive in nature. In future, these approaches can be expected to become the standard of care for these patients, further highlighting the need to create specialized centres of excellence for surgical treatment of the mitral valve.

Keywords: mitral valve repair, minimally invasive approach, robotic surgery.

Accepted: March 27, 2023; Published: April 12, 2023  Show citation