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...
Autores principales: | , , , , , , , , |
---|---|
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 |