Background: Despite numerous reported benefits of robotic mitral repair, the absolute number of procedures performed remain low in part to uncertainties about the necessary steps to launch a program. In this report, we describe our early outcomes and strategy with launching a successful new robotic mitral repair program.
Methods: Our multimodal strategic plan emphasized team education, hands-on technical preparation, stepwise advancement, and careful patient selection. Consultant service analytics and team debriefings allowed for iterative improvements.
Results: Between March 2022 and February 2024, 50 patients underwent robotic mitral repair at our institution. Average age at time of operation was 62 years with a Society of Thoracic Surgeons risk score of 0.58. Successful repairs were performed in 98% of patients. There was 1 conversion to sternotomy. There were no deaths, and there was minimal perioperative morbidity. On both predischarge and follow-up echocardiography, no patients had greater than mild mitral regurgitation.
Conclusions: Our work provides a model for establishing a successful robotic mitral program. An up-front emphasis on team education, careful preparation, proper patient selection, and feedback-driven improvements can accelerate the attainment of standards set by high-volume centers.
Keywords: minimally invasive; mitral repair; robotic mitral repair.
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