Robotic surgery has been hitting the headlines for years. Notwithstanding, it is not widely understood what robotic surgery is really about and what are the benefits and pitfalls of this technology.
Nowadays, when we talk about robotic surgery we mean surgery performed with the da Vinci telemanipulator (Intuitive Surgical, Sunnyvale, CA, USA). It is not the sole robotic system available, but it is indeed the most advanced authority cleared surgical robot. It is successfully commercialized worldwide and dominates almost 100% of the market.
This post refers to two intriguing presentations of this year’s EACTS meeting, held in Vienna. Both presentations deal with the chronically ischemic mitral valve (graded at least moderate) as a concomitant finding in patients qualifying for coronary artery bypass grafting. The indication for revascularization is an important differentiator: chronic mitral regurgitation due to past myocardial infarction can also be an entity by itself (i.e. without the need for a revascularization procedure). This entity poses a delicate and difficult question on the best option of how to deal with it. Surgery does not always deliver the desired result, the newer interventional option of Mitraclip® is currently in evolving investigation. I will come back to this issue with a dedicated post. Stay tuned!
Our clinical situation:
Let’s start with the most important thing: the patient is alive and well, hence the word “relative” mentioned in the title. This is “just” about a “technical” defeat. A brief description of the case: patient with severe coronary artery disease and a severe mitral valve regurgitation with indication to surgery (aortocoronary bypass with 4-5 grafts on all three main coronary artery branches and mitral valve repair).