A Population-Based Analysis of Robotic-Assisted Mitral Valve Repair

• Published in: The Annals of thoracic surgery Vol. 99; no. 5; pp. 1546 - 1553
• Main Authors: Paul, Subroto, MD, Isaacs, Abby J., MS, Jalbert, Jessica, PhD, Osakwe, Nonso C., MD, MPH, Salemi, Arash, MD, Girardi, Leonard N., MD, Sedrakyan, Art, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-05-2015
• Subjects: Adolescent; Adult; Aged; Cardiothoracic Surgery; Female; Health Care Costs; Heart Valve Diseases - complications; Heart Valve Diseases - mortality; Heart Valve Diseases - surgery; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Male; Middle Aged; Mitral Valve; Retrospective Studies; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - economics; Robotic Surgical Procedures - statistics & numerical data; Surgery; United States - epidemiology; Young Adult; United States; 35; 28
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2014.12.043

Background Robotic-assisted mitral valve repair is becoming more frequently performed in cardiac surgery. However, little is known about its utilization and safety at a national level. Methods Patients undergoing mitral valve repair in the United States from 2008 to 2012 were identified in the National Inpatient Sample. Inhospital mortality, complications, length of stay, and cost for patients undergoing robotic-assisted mitral valve repair were compared with patients undergoing nonrobotic procedures. Results We identified 50,408 isolated mitral valve repair surgeries, of which 3,145 were done with robotic assistance. In a propensity score matched analysis of 631 pairs of patients, we found no difference between patients undergoing robotic-assisted and nonrobotic-assisted mitral valve repair with respect to inhospital mortality, complications, or composite outcomes in unadjusted or multivariable analyses. Robotic-assisted mitral valve repair surgery was associated with a shorter median length of stay (4 versus 6 days, p < 0.001), and there was no difference in median total costs between the two procedures. Conclusions In our analysis of a large national database with its inherent limitations, robotic-assisted mitral valve repair was found to be safe, with an acceptable morbidity and mortality profile.