Skip to main content

Clinical Outcomes in Robotic Cardiac Surgery

  • Chapter
  • First Online:
  • 1401 Accesses

Abstract

Robotic (da Vinci™ system) assisted cardiac surgery was introduced in 1998 and was followed by sporadic case reports and small individual center series. Our group at the East Carolina Heart Institute (East Carolina University) led the United States Federal Drug Administration (FDA) trial that eventuated in cardiac surgical approval in 2002. Since then there has been a slow adoption of this technology. In recent years, however, there has been an increase and broader acceptance because of increasing robotic cardiac experience with system technological advances. This chapter reviews the latest worldwide experience and clinical outcomes of robot-assisted cardiac surgery.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Modi P, Hassan A, Chitwood Jr WR. Minimally invasive mitral valve surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2008;34:943–52.

    Article  PubMed  Google Scholar 

  2. Gammie JS, Zhao Y, Peterson ED, O’Brien SM, Rankin JS, Griffith BP. Less-invasive mitral valve operations: trends and outcomes from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg. 2010;90:1401–8.

    Article  PubMed  Google Scholar 

  3. Robicsek F. Robotic cardiac surgery: time told! J Thorac Cardiovasc Surg. 2008;135:243–6.

    Article  PubMed  Google Scholar 

  4. Carpentier A, Loulmet D, Aupecle B, Kieffer JP, Tournay D, Guibourt P, et al. Computer assisted open heart surgery. First case operated on with success. C R Acad Sci III. 1998;321:437–42.

    Article  CAS  PubMed  Google Scholar 

  5. Mohr FW, Falk V, Diegeler A, Autschback R. Computer-enhanced coronary artery bypass surgery. J Thorac Cardiovasc Surg. 1999;117(6):1212–4.

    Article  CAS  PubMed  Google Scholar 

  6. Grossi EA, LaPietra A, Applebaum RM, Ribakove GH, Galloway AC, et al. Case report of robotic instrument enhanced mitral valve surgery. J Thorac Cardiovasc Surg. 2000;120:1169–71.

    Article  CAS  PubMed  Google Scholar 

  7. Nifong LW, Chu VF, Bailey BM, Maziarz DM, Sorrell VL, Holbert D, et al. Robotic mitral valve repair: experience with the da Vinci system. Ann Thorac Surg. 2003;75:438–42.

    Article  PubMed  Google Scholar 

  8. Nifong LW, Chitwood WR, Pappas PS, Smith CR, Argenziano M, Starnes VA, et al. Robotic mitral valve surgery: a United States multicenter trial. J Thorac Cardiovasc Surg. 2005;129:1395–404.

    Article  PubMed  Google Scholar 

  9. Autschbach R, Onnasch JF, Falk V, Walther T, Kruger M, Schilling LO, et al. The Leipzig experience with robotic valve surgery. J Card Surg. 2000;15:82–7.

    Article  CAS  PubMed  Google Scholar 

  10. Tatooles AJ, Pappas PS, Gordon PJ, Slaughter MS. Minimally invasive mitral valve repair using the da Vinci robotic system. Ann Thorac Surg. 2004;77:1978–82.

    Article  PubMed  Google Scholar 

  11. Jones BA, Krueger S, Howell D, Meinecke B, Dunn S. Robotic mitral valve repair: a community hospital experience. Tex Heart Inst J. 2005;32:143–6.

    PubMed Central  PubMed  Google Scholar 

  12. McClure RS, Kiaii B, Novick RJ, Rayman R, Swinamer S, Kodera K, et al. Computer-enhanced tele-manipulation in mitral valve repair: preliminary experience in Canada with the da Vinci robotic system. Can J Surg. 2006;49:193–6.

    PubMed Central  PubMed  Google Scholar 

  13. Woo YJ. Robotic cardiac surgery. Int J Med Robot. 2006;2(3): 225–32.

    Article  PubMed  Google Scholar 

  14. Folliguet T, Vanhuyse F, Constantino X, Realli M, Laborde F. Mitral valve repair robotic versus sternotomy. Eur J Cardiothorac Surg. 2006;29:362–6.

    Article  PubMed  Google Scholar 

  15. Murphy DA, Miller JS, Langford DA, Snyder AB. Endoscopic robotic mitral valve surgery. J Thorac Cardiovasc Surg. 2006;132: 776–81.

    Article  PubMed  Google Scholar 

  16. Chitwood WR, Rodriguez E, Chu MWA, Hassan A, Ferguson TB, Vos PW, et al. Robotic mitral valve repairs in 300 patients: a single center experience. J Thorac Cardiovasc Surg. 2008;136(2): 436–41.

    Article  PubMed  Google Scholar 

  17. Rodriguez E, Nifong LW, Chu MWA, Wood W, Vos PW, Chitwood WR. Robotic mitral valve repair for anterior leaflet and bileaflet prolapse. Ann Thorac Surg. 2008;85:438–44.

    Article  PubMed  Google Scholar 

  18. Cheng W, Fontana GP, De Robertis MA, Mirocha J, Czer LS, Kass RM, et al. Is robotic mitral valve repair a reproducible approach? J Thorac Cardiovasc Surg. 2010;139:628–33.

    Article  PubMed  Google Scholar 

  19. Mihaljevic T, Jarrett CM, Gillinov AM, et al. Robotic repair of posterior mitral valve prolapse versus conventional approaches: potential realized. J Thorac Cardiovasc Surg. 2011;141:72–80.

    Article  PubMed  Google Scholar 

  20. Mihaljevic T, Pattakos G, Gillinov AM, Bawja G, Planinc M, Williams SJ, et al. Robotic posterior mitral leaflet repair: neochordal versus resectional techniques. Ann Thorac Surg. 2013;95:787–94.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Suri RM, Burkhart HM, Daly RC, Dearani JA, Park SJ, Sundt III TM, et al. Robotic mitral valve repair for all prolapse using techniques identical to open valvuloplasty: Establishing the benchmark against which percutaneous interventions should be judged. J Thorac Cardiovasc Surg. 2011;142:970–9.

    Article  PubMed  Google Scholar 

  22. Nifong LW, Rodriguez E, Chitwood WR. 540 consecutive robotic mitral valve repairs including concomitant atrial fibrillation ablation. Ann Thorac Surg. 2012;94:38–43.

    Article  PubMed  Google Scholar 

  23. Chu MW, Gersch KA, Rodriguez E, Nifong LW, Chitwood Jr WR. Robotic “haircut” mitral valve repair: posterior leaflet-plasty. Ann Thorac Surg. 2008;85:1460–2.

    Article  PubMed  Google Scholar 

  24. Mihaljevic T, Jarrett CM, Gillinov AM, Blackstone EH. A novel running annuloplasty suture technique for robotically assisted mitral valve repair. J Thorac Cardiovasc Surg. 2010;139:1343–4.

    Article  PubMed  Google Scholar 

  25. Dogan S, Aybek T, Westphal K, Mierdl S, Moritz A, Wimmer-Greinecker G. Computer-enhanced totally endoscopic sequential arterial coronary artery bypass. Ann Thorac Surg. 2001;72:610–1.

    Article  CAS  PubMed  Google Scholar 

  26. Loulmet D, Carpentier A, d’Attellis N, Berrebi A, Cardon C, Ponzio O, et al. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg. 1999;118:4–10.

    Article  CAS  PubMed  Google Scholar 

  27. Falk V, Diegeler A, Walther T, Banusch J, Brucerius J, Raumans J, et al. Total endoscopic computer enhanced coronary artery bypass grafting. Eur J Cardiothorac Surg. 2000;17:38–45.

    Article  CAS  PubMed  Google Scholar 

  28. Falk V, Diegeler A, Walther T, Jacobs S, Raumans J, Mohr FW. Total endoscopic off-pump coronary artery bypass grafting. Heart Surg Forum. 2000;3:29–31.

    CAS  PubMed  Google Scholar 

  29. Mohr FW, Falk V, Diegeler A, Walther T, Gummert JF, Bucerius J, et al. Computer-enhanced “robotic” cardiac surgery: experience in 148 patients. J Thorac Cardiovasc Surg. 2001;121:842–53.

    Article  CAS  PubMed  Google Scholar 

  30. Dogan S, Aybek T, Andressen E, Byhahn C, Mierdl S, Westphal K, et al. Totally endoscopic coronary artery bypass grafting on cardiopulmonary bypass with robotically enhanced telemanipulation: report of forty-five cases. J Thorac Cardiovasc Surg. 2002;123: 1125–31.

    Article  CAS  PubMed  Google Scholar 

  31. Subramanian VA, Patel NU, Patel NC, Loulmet DF. Robotic assisted multivessel minimally invasive direct coronary artery bypass with port-access stabilization and cardiac positioning: paving the way for outpatient coronary surgery? Ann Thorac Surg. 2005;79:1590–6.

    Article  PubMed  Google Scholar 

  32. Srivastava S, Gadasalli S, Agusala M, Kolluru R, Naidu J, Shroff M, et al. Use of bilateral internal thoracic arteries in CABG through lateral thoracotomy with robotic assistance in 150 patients. Ann Thorac Surg. 2006;8:800–6.

    Article  Google Scholar 

  33. Argenziano M, Katz M, Bonatti J, Srivastava S, Murphy D, Poirier R, et al. Results of the prospective multicenter trial of robotically assisted totally endoscopic coronary artery bypass grafting. Ann Thorac Surg. 2006;81:1666–74.

    Article  PubMed  Google Scholar 

  34. Bonaros N, Schachner T, Lehr E, Kofler M, Wiedemann D, Hong P, et al. Five hundred cases of robotic totally endoscopic coronary artery bypass grafting: predictors of success and safety. Ann Thorac Surg. 2013;95:803–12.

    Article  PubMed  Google Scholar 

  35. de Canniere D, Wimmer-Greinecker G, Cichon R, Gulielmos V, Van Praet F, Seshadri-Kreaden U, et al. Feasibility, safety, and efficacy of totally endoscopic coronary artery bypass grafting: multicenter European experience. J Thorac Cardiovasc Surg. 2007;134:710–6.

    Article  PubMed  Google Scholar 

  36. Caynak B, Sagbas E, Onan B, Onan IS, Sanisoglu I, Akpinar B. Robotically enhanced coronary artery bypass grafting: the feasibility and clinical outcome of 196 procedures. Int J Med Robot. 2009;5:170–7.

    Article  PubMed  Google Scholar 

  37. Bonatti J, Schachner T, Bonaros N, Oehlinger A, Wiedemann D, Ruetzler E, et al. Effectiveness and safety of total endoscopic left internal mammary artery bypass graft to the left anterior descending artery. Am J Cardiol. 2009;104:1684–8.

    Article  PubMed  Google Scholar 

  38. Katz MR, Van Praet F, de Canniere D, Murphy D, Siwek L, Seshadri-Kreaden U, et al. Integrated coronary revascularization: percutaneous coronary intervention plus robotic totally endoscopic coronary artery bypass. Circulation. 2006;114(1 Suppl):I473–6.

    PubMed  Google Scholar 

  39. Kiaii B, McClure RS, Stewart P, Rayman R, Swinamer SA, Suematsu Y, et al. Simultaneous integrated coronary artery revascularization with long-term angiographic follow-up. J Thorac Cardiovasc Surg. 2008;136(3):702–8.

    Article  PubMed  Google Scholar 

  40. Kappert U, Tugtekin SM, Cichon R, Braun M, Matschke K. Robotic totally endoscopic coronary artery bypass: a word of caution implicated by a five-year follow-up. J Thorac Cardiovasc Surg. 2008;135(4):857–62.

    Article  PubMed  Google Scholar 

  41. Gao C, Yang M, Wu Y, Wang G, Xiao C, Liu H, et al. Hybrid coronary revascularization by endoscopic robotic coronary artery bypass grafting on beating heart and stent placement. Ann Thorac Surg. 2009;87:737–41.

    Article  PubMed  Google Scholar 

  42. Bonatti JO, Zimrin D, Lehr EJ, Vesely M, Kon ZN, Wehman B, et al. Hybrid coronary revascularization using robotic totally endoscopic surgery: perioperative outcomes and 5-year results. Ann Thorac Surg. 2012;94:1920–6.

    Article  PubMed  Google Scholar 

  43. Bolotin G, Kypson AP, Nifong LW, Chitwood Jr WR. Robotically-assisted left atrial fibrillation ablation and mitral valve repair through a right mini-thoracotomy. Ann Thorac Surg. 2004;78:e63–4.

    Article  PubMed  Google Scholar 

  44. Loulmet DF, Patel NC, Patel NU, Frumkin WI, Santoni-Rugiu F, Langan MN, et al. First robotic endoscopic epicardial isolation of the pulmonary veins with microwave energy in a patient in chronic atrial fibrillation. Ann Thorac Surg. 2004;78:e24–5.

    Article  PubMed  Google Scholar 

  45. Akpinar B, Guden M, Sagbas E, Sanisoglu I, Caynak B, Bayramoglu Z. Robotic-enhanced totally endoscopic mitral valve repair and ablative therapy. Ann Thorac Surg. 2006;81(3):1095–8.

    Article  PubMed  Google Scholar 

  46. Reade CC, Johnson JO, Bolotin G, Freund Jr WL, Jenkins NL, Bower CE, et al. Combining robotic mitral valve repair and microwave atrial fibrillation ablation: techniques and initial results. Ann Thorac Surg. 2005;79(2):480–4.

    Article  PubMed  Google Scholar 

  47. Argenziano M, Garrido MJ, Williams MR, Nifong LW, Smith CR, Oz MC. A totally endoscopic, beating-heart approach to pulmonary vein isolation for the treatment of atrial fibrillation. Heart Surg Forum. 2002;5(Suppl II):S191.

    Google Scholar 

  48. Gerosa G, Bianco R, Buja G, di Marco F. Totally endoscopic robotic-guided pulmonary veins ablation: an alternative method for the treatment of atrial fibrillation. Eur J Cardiothorac Surg. 2004;26:450–2.

    Article  PubMed  Google Scholar 

  49. Jansens JL, Ducart A, Preumont N, Jottrand M, Stefanidis C, Stoupel E, et al. Pulmonary vein isolation by robotic-enhanced thoracoscopy for symptomatic paroxysmal atrial fibrillation. Heart Surg Forum. 2004;7(6):E595–8.

    Article  PubMed  Google Scholar 

  50. Cheema FH, Weisberg JS, Khalid I, Roberts Jr HG. Warm beating heart, robotic endoscopic Cox-cryomaze: an approach for treating atrial fibrillation. Ann Thorac Surg. 2009;87:966–8.

    Article  PubMed  Google Scholar 

  51. McAlister FA, Ezekowitz J, Hooton N, Vandermeer B, Spooner C, Dryden DM, et al. Cardiac resynchronization therapy for patients with left ventricular systolic dysfunction: a systematic review. JAMA. 2007;297:2502–14.

    Article  CAS  PubMed  Google Scholar 

  52. Alonso C, Leclercq C, d’Allonnes FR, Pavin D, Victor F, Mabo P, et al. Six year experience of transvenous left ventricular lead implantation for permanent biventricular pacing in patients with advanced heart failure: technical aspects. Heart. 2001;86:405–10.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  53. Derose Jr JJ, Belsley S, Swistel DG, Shaw R, Ashton Jr RC. Robotically assisted left ventricular epicardial lead implantation for biventricular pacing: the posterior approach. Ann Thorac Surg. 2004;77:1472–4.

    Article  PubMed  Google Scholar 

  54. DeRose JJ, Balaram S, Ro C, Swistel D, Steinberg JS, Joshi S, et al. Midterm follow-up of robotic biventricular pacing demonstrates excellent lead stability and improved response rates. Innovations. 2006;1:105–10.

    PubMed  Google Scholar 

  55. Navia JL, Atik FA, Grimm RA, Garcia M, Vega PR, Myhre U, et al. Minimally invasive left ventricular epicardial lead placement: surgical techniques for heart failure resynchronization therapy. Ann Thorac Surg. 2005;79:1536–44.

    Article  PubMed  Google Scholar 

  56. Kamath GS, Balaram S, Choi A, Kuteyeva O, Garikipati NV, Steinberg JS, et al. Long-term outcomes of leads and patients following robotic epicardial left ventricular lead placement for cardiac resynchronization therapy. PACE. 2011;34:235–40.

    Article  PubMed  Google Scholar 

  57. Murphy DA, Miller JS, Langford DA. Robot-assisted endoscopic excision of left atrial myxomas. J Thorac Cardiovasc Surg. 2005;130:596–7.

    Article  PubMed  Google Scholar 

  58. Woo YJ, Grand TJ, Weiss SJ. Robotic resection of an aortic valve papillary fibroelastoma. Ann Thorac Surg. 2005;80:1100–2.

    Article  PubMed  Google Scholar 

  59. Gao C, Yang M, Wang G, Wang J, Xiao C, Wu Y, et al. Excision of atrial myxoma using robotic technology. J Thorac Cardiovasc Surg. 2010;139:1282–5.

    Article  PubMed  Google Scholar 

  60. Schilling J, Engel AM, Hassan M, Smith JM. Robotic excision of atrial myxoma. J Card Surg. 2012;27:423–6.

    Article  PubMed  Google Scholar 

  61. Torracca L, Ismeno G, Alfieri O. Totally endoscopic computer-enhanced atrial septal defect closure in six patients. Ann Thorac Surg. 2001;72:1354–7.

    Article  CAS  PubMed  Google Scholar 

  62. Wimmer-Greinecker G, Dogan S, Aybek T, Khan MF, Mierdl S, Byhahn C, et al. Totally endoscopic atrial septal repair in adults with computer-enhanced tele-manipulation. J Thorac Cardiovasc Surg. 2003;126:465–8.

    Article  PubMed  Google Scholar 

  63. Argenziano M, Oz MC, Kohmoto T, Morgan J, Dimitui J, Mongero L, et al. Totally endoscopic atrial septal defect repair with robotic assistance. Circulation. 2003;108 Suppl 1:II191–4.

    PubMed  Google Scholar 

  64. Bonaros N, Schachner T, Oehlinger A, Ruetzler E, Kolbitsch C, Dichtl W, et al. Robotically assisted totally endoscopic atrial septal defect repair: insights from operative times, learning curves, and clinical outcome. Ann Thorac Surg. 2006;82:687–93.

    Article  PubMed  Google Scholar 

  65. Morgan JA, Peacock JC, Kohmoto T, Garrido MJ, Schanzer BM, Kherani AR, et al. Robotic techniques improve quality of life in patients undergoing atrial septal defect repair. Ann Thorac Surg. 2004;77:1328–33.

    Article  PubMed  Google Scholar 

  66. Suematsu Y, Mora BN, Mihaljevic T, del Nido PJ. Totally endoscopic robotic-assisted repair of patent ductus arteriosus and vascular ring in children. Ann Thorac Surg. 2005;80:2309–13.

    Article  PubMed  Google Scholar 

  67. Le Bret E, Papadatos S, Folliguet T, Carbognani D, Petrie J, Aggoun Y, et al. Interruption of patent ductus arteriosus in children: robotically assisted versus videothoracoscopic surgery. J Thorac Cardiovasc Surg. 2002;123:973–6.

    Article  PubMed  Google Scholar 

  68. Gao C, Yang M, Wang G, Wang J, Xiao C, Zhao Y. Totally endoscopic robotic ventricular septal defect repair. Innovations. 2010;5:278–80.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. Bruce Ferguson Jr. MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Hassan, A., Modi, P., Ferguson, T.B. (2014). Clinical Outcomes in Robotic Cardiac Surgery. In: Chitwood, Jr., W. (eds) Atlas of Robotic Cardiac Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-6332-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6332-9_6

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6331-2

  • Online ISBN: 978-1-4471-6332-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics