Longitudinal outcomes following international multicentre experience with robotic aortic valve replacement

作者：Lawrence M. Wei, Daniel Pereda, Danny Ramzy, Feras H. Khaliel, Ghulam Murtaza, James Hunter Mehaffey, Nai‐Hsin Chi, Robinson Poffo, Štěpán Černý, Jan Vojáček, Tristan D. Yan, Serguei I. Melnitchouk, Alberto C. Weber, Robert Lane Smith, Goya V. Raikar, Ali Darehzereshki, Arnar Geirsson, Arman Arghami, Jose Luis Navia, Johannes O. Bonatti, Vinay Badhwar · 发表于：European Journal of Cardio-Thoracic Surgery · 年份：2025 · DOI：10.1093/ejcts/ezaf103 · 被引用次数：13 · 研究领域：Cardiac and Coronary Surgery Techniques、Cardiac Valve Diseases and Treatments、Aortic Disease and Treatment Approaches

OBJECTIVES: In an effort to maintain the technical aspects of traditional prosthetic surgical aortic valve replacement (AVR) while reducing invasiveness and facilitate options for concomitant operations, transaxillary lateral mini-thoracotomy endoscopic robotic-assisted aortic valve replacement (RAVR) has been introduced. The present data highlight the contemporary international collaborative experience. METHODS: All consecutive patients undergoing standardized RAVR across 10 international sites (1/2020-7/2024) were evaluated using a central database with 1 year follow-up. RESULTS: A total of 300 patients were analysed with a median predicted risk of 1.6% with aortic stenosis in 85.7%, nearly half with bicuspid valves. Biological prostheses were implanted in 220 (73.3%) with a median valve size 23 mm, 10% receiving aortic root enlargement, with 17% of all patients undergoing concomitant procedures. Median cross-clamp 120 min with no conversions to sternotomy. Median length of stay was 5 days, 4.3% with prolonged ventilation, 1.7% renal failure, 1.0% stroke and 8.3% required re-thoracotomy for evacuation of haemothorax. There were two 30-day operative mortalities (0.7%). The new permanent pacemaker rate for the full cohort was 2.6%. Of 163 patients with complete 1-year clinical and echocardiographic follow-up, mean aortic valve gradient was 10 mmHg and all but 2 patients (1.2%) had trace to no prosthetic or paravalvular insufficiency. CONCLUSIONS: RAVR is safe and effective, p...