Robotically controlled video-assisted port-access mitral valve surgery.

From 1997 to 2000, 221 patients underwent mitral valve surgery through a mini-thoracotomy, using a port-access endovascular cardiopulmonary bypass system in 38 and a transthoracic clamp in 183. In 120 patients, exposure of the mitral valve was facilitated by an endoscope attached to a voice-controlled robotic arm (AESOP 3000). The mitral valve was repaired in 26 patients and replaced in 195; 24 were redo cases. Operating time was 3.5 ± 1.2 hours, aortic crossclamp time was 58 ± 16 minutes, intensive care unit stay was 22 ± 7 hours, and hospital stay was 6.4 ± 1.2 days. Median postoperative blood loss was 332 ± 104 mL. There was 1 hospital death. On follow-up at 16.4 ± 12.2 months, there was no late death or reoperation. New York Heart Association functional class improved from 2.6 ± 0.5 to 1.4 ± 0.8. Use of video and robotic assistance minimized incision length and allowed visualization of the whole mitral valve apparatus. The transthoracic clamp facilitated aortic crossclamping and injection of cardiople...