New technology allows for complex mitral valve (MV) repairs to be performed less invasively using the da Vinci(tm) robotic system. We have performed over 315 robotic mitral valve repairs (RMVR), the world's largest series, with a failure rate of 4.44%.

We performed a robotic assisted posterior mitral leaflet triangular resection, sliding annuloplasty, chordal transfer and a 36-mm annuloplasty band placement in a 55 year old man with severe, symptomatic MV regurgitation related to myxomatous disease. This procedure was performed through three 1-cm instrument ports and a 3-cm incision for assistant and camera access.

Our patient underwent an uncomplicated RMVR and was weaned from cardiopu cardiopulmonary bypass without difficulty. Postoperative transesophageal echocardiogram revealed preserved left ventricular function with no residual regurgitation or systolic anterior motion of the anterior leaflet of the MV. He was discharged home on postoperative day three and returned to normal activities in three weeks.

Minimally invasive robotically-assisted approaches are gaining popularity due to the reduced need for blood transfusions, decreased lengths of stay, and improved recovery time as compared to traditional sternotomy-based operations without increasing patient mortality or morbidity.