Robotic-Assisted Third-Time Redo Mitral Valve Replacement.

Robotic-assisted approaches in cardiac surgery are becoming an increasingly common form of minimally invasive surgery. Recent literature has shown robotic-assisted techniques to be superior to traditional sternotomy in infection rates, bleeding, length of hospital stay, and postoperative quality of life. Although there are growing numbers of centers performing robotic mitral valve (MV) surgery, this approach is usually reserved for first-time MV repair. This case report describes a patient with two previous MV surgical procedures complicated by a late paravalvular leak that was unsuccessfully treated with four Amplatzer devices (AGA Medical, Inc, Plymouth, MN). A successful, totally endoscopic, robotic-assisted, third-time reoperative MV replacement was performed in this challenging patient.