Robotic Mitral Valve Repair for Simple and Complex Degenerative Disease: Midterm Clinical and Echocardiographic Quality Outcomes.

摘要: Background —Severe primary (degenerative) mitral valve regurgitation (MR) is repaired with durable results when "simple" single scallop disease addressed. The mid-term quality outcomes of minimally invasive repair for "complex disease" are unknown however. Methods and Results —From January 2008 to 2015, 487 patients (56±11 years, 360 men, ejection fraction 65±6%, 98.8% complete follow-up) underwent robotic severe non-ischemic degenerative MR. Simple pathology was addressed in 289/487 (59%) complex (all others) performed 198/487 (41%). Four died during follow-up a 5-year survival rate 99.5% (99.4% simple; complex, HR=0.48, 95% CI 0.05-4.59); NYHA functional class I/II documented 97.9%(477/487). Eight had recurrence ≥moderate MR, (4 simple, 4 complex), 5 year freedom from MR 94.6% (96.2% 92.7%, p=0.67; HR=1.36, 0.34-5.43). Seven (2 reoperation, reoperation 97.7% (99.2% simple 95.7% p=0.13; HR=3.35, 0.65-17.32). Conclusions —At large tertiary care referral center, after correction excellent, very high survival, infrequent complications low likelihood - regardless complexity. Awareness these improvements outcome important inform contemporary decisions regarding high-quality alternatives conventional percutaneous repair.