Comparison of postoperative outcomes between robotic mitral valve replacement and conventional mitral valve replacement

Background Robotic mitral valve surgery continues to become widespread all over the world in direct proportion to the developing technology. In this study, we aimed to compare the postoperative results of robotic mitral valve replacement and conventional mitral valve replacement. Methods A total of consecutive 130 patients who underwent robotic mitral valve replacement and conventional mitral valve replacement with full sternotomy between 2014 and 2020 were included in our study. All patients were divided into two groups: Group I, with 64 patients who underwent robotic mitral valve replacement and Group II, with 66 patients with conventional full sternotomy. General demographic data (age, gender, body weights, etc.), comorbidities (hypertension, diabetes mellitus, chronic obstructive pulmonary disease, peripheral artery disease, hyperlipidemia, etc.), intraoperative variables (cardiopulmonary bypass times, and cross-clamp times), postoperative ventilation times, drainage amounts, transfusion amount, inotropic need, revision, arrhythmia, intensive care and hospital stay times, and mortality were analyzed retrospectively. Results There was no significant difference between demographic data, such as age, gender, body kit index, and preoperative comorbid factors of both patient groups (p > .05). Cardiopulmonary bypass time (204.12 +/- 45.8 min) in Group I was significantly higher than Group II (98.23 +/- 17.8 min) (p < .001). Cross-clamp time in Group I (143 +/- 27.4 min) was significantly higher than Group II (69 +/- 15.2 min) (p < .001). Drainage amount in Group I (290 +/- 129 cc) was significantly lower than Group II (561 +/- 136 cc) (p < .001). The erythrocyte suspension transfusion requirement was 0.4 +/- 0.3 units in Group I; it was 0.9 +/- 1.2 units in Group II, and this requirement was found to be significantly lower in Group I (p = .014). While the mean mechanical ventilation time was 5.3 +/- 3.9 h in Group I, it was 9.6 +/- 4.2 h in Group II. It was significantly lower in Group I (p = .001). Accordingly, intensive care stay (p = .006) and hospital stay (p = .003) were significantly lower in Group I. In the early postoperative period, three patients in Group I and four patients in Group II were revised due to bleeding. In the postoperative hospitalization period, neurological complications were observed in one patient in Group I and two patients in Group II. Two patients in Group I returned to the sternotomy due to surgical difficulties. Two patients died in both groups postoperatively, and there was no significant difference in mortality (p = .97). Conclusion According to conventional methods, robotic mitral valve replacement is an effective and reliable method since total perfusion and cross-clamp times are longer, drainage amount and blood transfusion need are less, and ventilation time, intensive care, and hospital stay time are shorter.

Automated summary

Robotic mitral valve replacement is an effective and reliable method compared to conventional mitral valve replacement, with shorter ventilation time, intensive care, and hospital stay time, yet longer total perfusion and cross-clamp times, lower drainage amount and blood transfusion need.