Cargando…

A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair

OBJECTIVE: Robot-assisted surgery is a minimally invasive approach for repairing the mitral valve. This study aimed to assess its safety and clinical efficacy when compared with conventional sternotomy, partial sternotomy, and right minithoracotomy. METHODS: A systematic review of peer-reviewed stud...

Descripción completa

Detalles Bibliográficos
Autores principales: Fatehi Hassanabad, Ali, Nagase, Fernanda N. I., Basha, Ameen M., Hammal, Fadi, Menon, Devidas, Kent, William D. T., Ali, Imtiaz S., Nagendran, Jeevan, Stafinski, Tania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846568/
https://www.ncbi.nlm.nih.gov/pubmed/36529985
http://dx.doi.org/10.1177/15569845221141488
_version_ 1784871216476061696
author Fatehi Hassanabad, Ali
Nagase, Fernanda N. I.
Basha, Ameen M.
Hammal, Fadi
Menon, Devidas
Kent, William D. T.
Ali, Imtiaz S.
Nagendran, Jeevan
Stafinski, Tania
author_facet Fatehi Hassanabad, Ali
Nagase, Fernanda N. I.
Basha, Ameen M.
Hammal, Fadi
Menon, Devidas
Kent, William D. T.
Ali, Imtiaz S.
Nagendran, Jeevan
Stafinski, Tania
author_sort Fatehi Hassanabad, Ali
collection PubMed
description OBJECTIVE: Robot-assisted surgery is a minimally invasive approach for repairing the mitral valve. This study aimed to assess its safety and clinical efficacy when compared with conventional sternotomy, partial sternotomy, and right minithoracotomy. METHODS: A systematic review of peer-reviewed studies comparing robot-assisted mitral valve repair with conventional sternotomy, partial sternotomy, and right minithoracotomy was conducted following Cochrane Collaboration guidelines. Meta-analyses were performed where possible. RESULTS: The search strategy yielded 15 primary studies, of which 12 compared robot-assisted with conventional sternotomy, 2 compared robot-assisted with partial sternotomy, and 6 compared robot-assisted with right minithoracotomy. The overall quality of evidence was low, and there was a lack of data on long-term outcomes. Individual studies and pooled data demonstrated that robotic procedures were comparable to conventional sternotomy and other minimally invasive approaches with respect to the rates of stroke, renal failure, reoperation for bleeding, and mortality. Robot-assisted mitral valve repair was superior to conventional sternotomy with reduced atrial fibrillation, intensive care unit and hospital stay, pain, time to return to normal activities, and physical functioning at 1 year. However, robot-assisted mitral valve repair had longer cardiopulmonary, aortic cross-clamp, and procedure times compared with all other surgical approaches. CONCLUSIONS: Based on current evidence, robot-assisted mitral valve repair is comparable to other approaches for safety and early postoperative outcomes, despite being associated with longer operative times. Ideally, future studies will be randomized controlled trials that compare between robot-assisted surgery, conventional surgery, and other minimally surgery approaches focusing on hard clinical outcomes and patient-reported outcomes.
format Online
Article
Text
id pubmed-9846568
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-98465682023-01-19 A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair Fatehi Hassanabad, Ali Nagase, Fernanda N. I. Basha, Ameen M. Hammal, Fadi Menon, Devidas Kent, William D. T. Ali, Imtiaz S. Nagendran, Jeevan Stafinski, Tania Innovations (Phila) Review Article OBJECTIVE: Robot-assisted surgery is a minimally invasive approach for repairing the mitral valve. This study aimed to assess its safety and clinical efficacy when compared with conventional sternotomy, partial sternotomy, and right minithoracotomy. METHODS: A systematic review of peer-reviewed studies comparing robot-assisted mitral valve repair with conventional sternotomy, partial sternotomy, and right minithoracotomy was conducted following Cochrane Collaboration guidelines. Meta-analyses were performed where possible. RESULTS: The search strategy yielded 15 primary studies, of which 12 compared robot-assisted with conventional sternotomy, 2 compared robot-assisted with partial sternotomy, and 6 compared robot-assisted with right minithoracotomy. The overall quality of evidence was low, and there was a lack of data on long-term outcomes. Individual studies and pooled data demonstrated that robotic procedures were comparable to conventional sternotomy and other minimally invasive approaches with respect to the rates of stroke, renal failure, reoperation for bleeding, and mortality. Robot-assisted mitral valve repair was superior to conventional sternotomy with reduced atrial fibrillation, intensive care unit and hospital stay, pain, time to return to normal activities, and physical functioning at 1 year. However, robot-assisted mitral valve repair had longer cardiopulmonary, aortic cross-clamp, and procedure times compared with all other surgical approaches. CONCLUSIONS: Based on current evidence, robot-assisted mitral valve repair is comparable to other approaches for safety and early postoperative outcomes, despite being associated with longer operative times. Ideally, future studies will be randomized controlled trials that compare between robot-assisted surgery, conventional surgery, and other minimally surgery approaches focusing on hard clinical outcomes and patient-reported outcomes. SAGE Publications 2022-12-18 /pmc/articles/PMC9846568/ /pubmed/36529985 http://dx.doi.org/10.1177/15569845221141488 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Article
Fatehi Hassanabad, Ali
Nagase, Fernanda N. I.
Basha, Ameen M.
Hammal, Fadi
Menon, Devidas
Kent, William D. T.
Ali, Imtiaz S.
Nagendran, Jeevan
Stafinski, Tania
A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair
title A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair
title_full A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair
title_fullStr A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair
title_full_unstemmed A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair
title_short A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve Repair
title_sort systematic review and meta-analysis of robot-assisted mitral valve repair
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846568/
https://www.ncbi.nlm.nih.gov/pubmed/36529985
http://dx.doi.org/10.1177/15569845221141488
work_keys_str_mv AT fatehihassanabadali asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT nagasefernandani asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT bashaameenm asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT hammalfadi asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT menondevidas asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT kentwilliamdt asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT aliimtiazs asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT nagendranjeevan asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT stafinskitania asystematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT fatehihassanabadali systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT nagasefernandani systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT bashaameenm systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT hammalfadi systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT menondevidas systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT kentwilliamdt systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT aliimtiazs systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT nagendranjeevan systematicreviewandmetaanalysisofrobotassistedmitralvalverepair
AT stafinskitania systematicreviewandmetaanalysisofrobotassistedmitralvalverepair