Endoaortic balloon occlusion versus transthoracic cross-clamp for totally endoscopic robotic mitral valve surgery: a retrospective cohort study.

Autor: Yost CC; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Rosen JL; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Mandel JL; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Prochno KW; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Wu M; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Komlo CM; Section of Cardiothoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA., Guy TS; Northeast Georgia Physicians Group Cardiovascular Surgery and Thoracic Surgery, 200 South Enota Drive Northeast, Suite 380, Gainesville, GA, 30501, USA. Sloane.Guy@nghs.com.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2023 Oct; Vol. 17 (5), pp. 2305-2313. Date of Electronic Publication: 2023 Jun 20.
DOI: 10.1007/s11701-023-01654-3
Abstrakt: Endoaortic balloon occlusion (EABO) and transthoracic cross-clamping have been shown to have comparable safety profiles for aortic occlusion in minimally invasive mitral valve surgery (MIMVS). However, few studies have focused exclusively on the totally endoscopic robotic approach. We sought to compare outcomes for patients undergoing totally endoscopic robotic mitral valve surgery with aortic occlusion via EABO and transthoracic clamping after a period where EABO was unavailable required us to use the transthoracic clamp. Retrospective review identified 113 patients who underwent robotic mitral valve surgery at our facility between 2019 and 2021 with EABO (n = 71) or transthoracic clamping (n = 42). Relevant data were extracted and compared. Preoperative characteristics were similar other than a higher rate of coronary artery disease [EABO: 69.0% (49/71) vs clamp: 45.2% (19/42), p = .02] and chronic lung disease [EABO: 38.0% (27/71) vs clamp: 9.5% (4/42), p < .01] in the EABO group. Median percutaneous cardiopulmonary bypass time, operative time, and cross-clamp time were comparable. Similar rates of postoperative bleeding complications were observed, and no aortic complications were observed. One patient in each group underwent conversion to an open approach. 30-day mortality and readmission rates were comparable. EABO and transthoracic clamp were associated with similar bleeding and aortic outcomes, and mortality and readmission rates were comparable at thirty days postoperatively. Our findings support the comparable safety of the two techniques, which is well documented in studies encompassing all MIMVS techniques, within the specific context of the totally endoscopic robotic approach.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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