TUESDAY, June 19, 2018 (HealthDay News) — Robotic and minimally invasive (mini) approaches to mitral surgery are associated with high rates of mitral repair, although robotic patients have longer procedural time, according to a study published online June 18 in Heart.
Robert B. Hawkins, M.D., from the University of Virginia in Charlottesville, and colleagues stratified patients undergoing non-emergent isolated mitral valve operations according to surgical approach: robotic, mini, and conventional sternotomy. Robotic cases (372 patients) were propensity-score matched to conventional and mini approaches (314 and 295, respectively).
The researchers found that the robotic cases were well matched to the conventional and mini cases, with no significant differences at baseline. Despite similar rates of degenerative disease, the robotic and mini cohorts had higher rates of mitral repair (91 percent, versus 76 percent for conventional). Procedural times were longest in the robotic cohort, including operative time, versus conventional (224 versus 168 minutes) and mini (222 versus 180 minutes). Compared with the conventional approach, the robotic approach had comparable outcomes, although fewer discharges to a facility were seen (7 versus 15 percent) and there was one day less in the hospital. Compared with the mini approach, the robotic approach correlated with more transfusions (15 versus 5 percent), higher rates of atrial fibrillation (26 versus 18 percent), and one day longer average hospital stay.
“All three approaches provide excellent outcomes, thus patient preference and surgeon experience should dictate the approach for mitral valve surgery,” the authors write.
Two authors disclosed financial ties to the pharmaceutical and medical device industries.
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