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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Robotic mitral valve replacement(AME PUBLISHING COMPANY, 2022-01-01) Arslanhan, Gokhan; Senay, Sahin; Kocyigit, Muharrem; Gullu, Ahmet Umit; Alhan, CemBackground: This study evaluates the clinical outcome of patients with robotic mitral valve replacement (MVR).Methods: Between January 2010 and April 2022, 117 consecutive patients underwent robotic MVR with or without additional cardiac procedures. All procedures were completed by a single surgical team with Da Vinci Robotic Systems. Perioperative variables and early clinical outcomes were recorded.Results: Mean age and EuroScore II of the patients were 57.1 +/- 12.9 and 5.1 +/- 5.7, respectively. Isolated MVR was performed in 55 (47.0\%) patients and combined cardiac procedures were performed in 62 (53.0\%) patients. Additional procedures included: ablation for atrial fibrillation, tricuspid valve replacement, tricuspid valve repair, left atrial appendix ligation, patent foramen ovale closure, left atrial thrombectomy and septal myectomy for hypertrophic obstructive cardiomyopathy. Mean cardiopulmonary bypass time and cross clamp time were 143 +/- 54 and 93 +/- 37 minutes, respectively. Mean intensive care unit stay time was 26.5 +/- 26.0 hours. Postoperative stroke was observed in one (0.9\%) patient and new onset renal failure was observed in two (1.7\%) patients. Perioperative and postoperative early mortality was observed in three (2.6\%) patients, which was lower than expected.Conclusions: Robotic MVR is feasible and can be performed with good early postoperative outcomes. A majority of the patients require additional cardiac procedures.Item Percutaneous cannulation for cardiopulmonary bypass in robotic mitral valve surgery with zero groin complications(WILEY, 2022-01-01) Bastopcu, Murat; Senay, Sahin; Gullu, Ahmet U.; Kocyigit, Muharrem; Alhan, CemIntroduction Robotic valve surgery utilizes the femoral vessels to set up cardiopulmonary bypass (CPB) which translates to groin wound and lower extremity vascular complications. A less invasive technique is a totally percutaneous bypass using vascular closure devices (VCDs) with concerns for lower limb ischemia and arterial stenosis. Since April 2018, we have adopted the standard use of total percutaneous CPB in our robotic mitral cases. We report our institutional results with this technique. Methods All consecutive patients who underwent robotic mitral valve surgery between April 2018 and December 2020 in our institution were included in our study. Hospital database data on demographics, operative variables, and surgical outcomes were recorded and analyzed. Results Robotic mitral valve surgeries were performed on 32 consecutive patients (mean age 57.2 +/- 14.8) between April 2018 and December 2020. None of our patients developed an infection at any site. Seroma, hematoma, or pseudoaneurysm were not observed at puncture sites. Surgical repair of the femoral vessels or an additional VCD was not necessary for any of our patients. Patients were followed up for a mean duration of 23.5 months. Our patients did not present with a late wound infection, a seroma, or a pseudoaneurysm, nor had complaints of limb ischemia or claudication. Conclusion Total percutaneous bypass is the least invasive method of establishing extracorporeal circulation for cardiac surgery and can be performed with excellent results. The benefits of robotic surgery can be expanded with better results in groin cannulation by the adoption of total percutaneous CPB.