Robot-assisted sutureless minimally invasive mitral valve repair.

Our institution has performed over 100 robot-assisted mitral valve repairs. The procedure has shown many advantages to conventional sternotomy-based repair. However, the robotic approach leads to longer cross-clamp and bypass times than conventional sternotomy. As a result of the increased risk of myocardial damage and arrhythmias from lengthy arrest times, nitinol U-clips have been used in the laboratory and currently in patients for the tissue-annuloplasty ring approximation. The technology replaces the time-consuming task of knot tying, as well as provides better visualization during placement of the annuloplasty ring. The animal studies show excellent tissue incorporation. Short-term echocardiographic imaging shows durability without evidence of mitral stenosis or regurgitation. Further studies are ongoing in our patient population, and the data suggest shorter, more efficient and effective robot-assisted mitral valve repairs.