Cardiac Surgeon and Surgical Director, TAVR, Heart & Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
To improve outcomes with robotically assisted mitral valve surgery, Cleveland Clinic conducted a study evaluating outcomes in 1,000 consecutive cases. Primary areas of interest were to determine whether increased surgical experience with robotic techniques improved outcomes and to identify opportunities that could improve procedural processes. Results showed that these surgeries were effective and safe in terms of improvements in procedure time, transfusion rates, stroke risk, number of mitral valve replacements, and number of conversions to sternotomy. The development and implementation of a patient-selection algorithm halfway through the study further improved outcomes by refining patient eligibility criteria. This study showed that use of a focused preoperative assessment with an algorithm-driven patient selection process combined with increased technical expertise can enhance outcomes with robotic mitral valve surgery.