Objective: To review our first 300 consecutive robotic mitral valve repairs (R-MVr) from June, 2005 to October 2012 comparing our previously reported initial 120 with the subsequent 180 procedures. Methods: Our initial 120 R-MVr were compared to our recent 180 consecutive cases. All patients received an annuloplasty band and one or more of the following: leaflet resection, secondary chordal transposition and/or neochordal replacement and edge-to-edge repair. Results: All 300 patients had preoperative severe mitral regurgitation (MR). There were no differences in preoperative characteristics between the initial and recent cohorts. The incidence of anterior and posterior leaflet prolapse was similar in both groups while Barlow syndrome was higher in group 2. There was 1 hospital mortality (none in the last 180). Eight patients required MV replacement via sternotomy (6/120, 2/180). One patient in each group had MV re-repair via right mini-thoracotomy and one in the first group required MV replacement during the original procedure. Two of the 180 patients had CVA, both recovered (none in last 120). Cross clamp times decreased from 116 to 91 minutes. Post-pump echocardiograms showed none/trace MR in 86.1% of the last 180 cases and mild MR in 11.1%. Follow-up echo from 1 month to more than 1 year showed none/trace MR in 70.7% and mild in 21.7%. Ten patients (6.0%) had moderated MR and 1 patient (0.6%) had severe. Conclusions: Most complications occurred in the early experience using the first generation daVinci robot. The newer da Vinci Si HD system has made R-MVr of all types of degenerative MV pathology reproducible.
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