Robotic vs. sternotomy mitral valve replacement in rheumatic disease: early postoperative outcomes compared
GENERAL THORACIC AND CARDIOVASCULAR SURGERY, cilt.74, sa.2, ss.125-132, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 74 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11748-025-02187-2
- Dergi Adı: GENERAL THORACIC AND CARDIOVASCULAR SURGERY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.125-132
- Trakya Üniversitesi Adresli: Hayır
Özet
Objective This study aims to compare early postoperative outcomes of robotic-assisted mitral valve replacement (r-MVR) and conventional sternotomy-based mitral valve replacement (c-MVR) in patients with rheumatic mitral valve disease (RMVD). Methods A retrospective analysis included 225 adult patients who underwent isolated MVR for RMVD between November 2018 and December 2023. Among them, 105 underwent r-MVR and 120 underwent c-MVR. Evaluated parameters included operative time, cardiopulmonary bypass (CPB) and cross-clamp times, extubation time, ICU and hospital stay, chest drainage, mechanical ventilation duration, postoperative pain scores, complications, and 30-day mortality. Results Patients in the r-MVR group showed significantly better short-term outcomes. Postoperative drainage was lower (323 +/- 154 mL vs. 532 +/- 320 mL), red blood cell transfusion was reduced (0.8 +/- 0.9 vs. 2.3 +/- 2.4 units), and intubation time was shorter (10.2 +/- 6.2 vs. 17.7 +/- 21.3 h) compared to the c-MVR group (p < 0.001). Additionally, hospital stay (6.8 +/- 3.7 vs. 9.4 +/- 4.7 days) and pain scores (2.4 +/- 0.85 vs. 3.5 +/- 0.96) were significantly improved in the robotic group. However, CPB and cross-clamp times were longer in r-MVR (168 +/- 47 vs. 104 +/- 31 min and 106 +/- 34 vs. 69 +/- 21 min, respectively; p < 0.001). Complication and 30-day mortality rates were similar between groups. Conclusion Robotic-assisted mitral valve replacement is a safe and effective alternative to conventional surgery in RMVD. Despite longer operative times, it offers better early recovery and may be preferred in experienced centers for selected patients.