Cardiothoracic Surgery — Mitral Valve Repair

If your doctor recommends surgery to treat mitral valve prolapse, you may be a candidate for robotic-assisted mitral valve repair, potentially the most effective least invasive treatment option available.

Robotic-assisted mitral valve repair is an alternative to conventional open heart surgery — the traditional way to treat mitral valve disease. Robotic-assisted mitral valve repair is performed using the da Vinci Surgical System, enabling your surgeon to operate with unparalleled precision and control through a few small incisions.

The da Vinci Surgical System can help your surgeon repair your valve and help you avoid mitral valve replacement, in which your natural valve tissues are cut away and replaced with an artificial valve. This is important because a repair can provide you with many significant advantages as compared with mitral valve replacement, including no need to take life-long blood thinners, less need for reoperation^1,2, reduced risk of surgical complications³, a higher long-term survival rate^4,5,6, and improved heart function⁴. A recent study suggests that the da Vinci System may allow surgeons to complete 50% more repairs than they can when using an open surgical approach.⁷

In addition to avoiding the pain and trauma of sternotomy — a surgical incision through the breastbone — and rib spreading, robotic-assisted mitral valve repair provides most patients with the following benefits over open surgery:

• Less risk of infection
• Less blood loss and need for blood transfusions
• Shorter hospital stay
• Significantly less pain and scarring
• Faster recovery
• Quicker return to normal activities
• And a potentially better clinical outcome

As with any surgery, these benefits cannot be guaranteed, as surgery is both patient and procedure specific. While robotic-assisted mitral valve repair is considered safe and effective, it may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

1. Rodgers, E. Heart valve repair or replacement for mitral valve regurgitation or prolapse. WebMD. March 10, 2005 Bach DS. Choice of prosthetic heart valves: update for the next generation. J Am Coll Cardiol. 2003 Nov 19;42(10):1717-9.

2. Ruel M, Kulik A, Rubens FD, Bedard P, Masters RG, Pipe AL, Mesana TG. Late incidence and determinants of reoperation in patients with prosthetic heart valves. Eur J Cardiothorac Surg. 2004 Mar;25(3):364-70.

3. Thourani VH, Weintraub WS, Guyton RA, et al. Outcomes and Long-Term Survival for Patients Undergoing Mitral Valve Repair Versus Replacement. Circulation. 2003;108:298-304 (Emory University Atlanta)

4. Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL: Valve repair improves the outcome of surgery for mitral regurgitation: a long-term study. Circulation. 1995; 91:1022-8

5. Gillinov AM, Wierup PN, Blackstone EH, et al. Is Repair Preferable to Replacement for Ischemic Mitral Regurgitation? J Thorac Cardiovasc Surg 2001 Dec; 122(6):1125-41 (Cleveland Clinic)

6. Grossi E, Goldberg J, LaPietra A, et al. Ischemic mitral valve reconstruction and replacement: Comparison of long term survival and complications. J Thorac Cardiovasc Surg 2001 Dec; 122(6):1107-24 (NYU)

7. 96.2% received a repair with da Vinci Surgery, as reported by Douglas Murphy, MD, compared to 60% of patients in the Fall 2005 Sternotomy database, where 42,000 out of 70,000 received a replacement. See Society for Thoracic Surgeons & Duke Clinical Research Institute. Executive Summary. STS Fall 2005 Report. Murphy D, Smith M, Siwek L, Langford D, Robinson JR, Reynolds B, Seshadri-Kreaden U, Engel A. Multicenter Mitral Valve Study: a Lateral Approach using the da Vinci Surgical System. Pending publication. Data on file with Intuitive Surgical, Inc.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.