Robotic Mitral Valve Repair: Indication for Surgery Does Not Influence Early Outcomes.

Autor:	Maltais S; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN. Electronic address: simonmaltais@mac.com., Anwer LA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN; Department of General Surgery, University of Illinois/Metropolitan Group of Hospitals, Chicago., Daly RC; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN., Poddi S; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN., Topilsky Y; Department of Cardiovascular Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Enrique-Sarano M; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN., Michelena HI; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN., Mauermann WJ; Department of Anesthesiology, Mayo Clinic, Rochester, MN., Dearani JA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings [Mayo Clin Proc] 2019 Nov; Vol. 94 (11), pp. 2263-2269. Date of Electronic Publication: 2019 Oct 18.
DOI:	10.1016/j.mayocp.2019.05.025
Abstrakt:	Objective: To evaluate the outcomes of robotic mitral valve repair (MVr) by primary indication per American Heart Association guidelines for surgery: class I vs class IIa. Patients and Methods: From January 1, 2008, through September 30, 2016, 603 patients underwent robotic MVr for severe primary mitral regurgitation. Medical records of 576 consenting patients were retrospectively reviewed to determine the primary indication for surgery. Patients were stratified into class I or class IIa, and preoperative, intraoperative, and postoperative variables were compared. Results: Of 516 patients, 428 (83%) had class I indication and 88 (17%) had class IIa indication for surgery. Preoperatively, no significant differences were observed between both cohorts. Importantly, a significantly higher number of patients with class I indication underwent MVr for bileaflet prolapse (172 of 428 [40%] vs 21 of 88 [25%]; P=.03). Early MVr outcomes indicated recurrent mitral regurgitation (moderate or greater) in only 12 of 576 (2%), and no significant differences were observed between classes (P=.23). Apart from parameters for ventricular size, all other intraoperative and postoperative variables were comparable between both cohorts. Conclusion: Comparable outcomes were indicated across all classes of indications for MVr surgery. These results continue to support the use of this surgical technique, even in less sick patients. Early referral along with more extensive robotic MVr experience will likely result in further improvements in long-term outcomes. (Copyright © 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu