Robotic Versus Conventional Sternotomy Mitral Valve Surgery: A Systematic Review and Meta-Analysis
Background: Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS.
Methods: An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS. Pre-defined primary outcomes of interest included all-cause mortality, cerebrovascular accidents (CVA) and re-operation for bleeding. Secondary outcomes of interest included cross clamp time, cardiopulmonary bypass (CPB) time, intensive care unit (ICU) and hospital length of stay (LOS), postoperative atrial fibrillation (POAF) and red blood cell (RBC) transfusion.
Results:The search strategy identified fourteen studies qualifying for inclusion in this meta-analysis comparing RMVS to CSMVS. The outcomes of 6,341 patients (2,804 RMVS and 3,537 CSMVS) were included. RMVS had significantly lower mortality when compared to CSMVS group in both the unmatched [odds ratio (OR) 0.33; 95% confidence interval (CI): 0.19–0.57; P
Conclusions: Current evidence on comparative outcomes of RMVS and CSMVS is limited with only lowquality studies currently available. This present meta-analysis suggests that RMVS may have lower mortality and shorter ICU and hospital LOS, however CSMVS may be associated with significantly shorter cross clamp and CPB times. Further analysis of high-quality studies with randomized data is required to verify these results.
Williams, Michael L.; Hwang, Bridget; Huang, Linna; Wilson-Smith, Ashley; Brookes, John; Eranki, Aditya; Yan, Tristan D.; Guy, T. Sloane; and Bonatti, Johannes, "Robotic Versus Conventional Sternotomy Mitral Valve Surgery: A Systematic Review and Meta-Analysis" (2022). Department of Surgery Faculty Papers. Paper 227.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
This article is the author's final published version in Annals of Cardiothoracic Surgery, Volume 11, Issue 5, Sept. 2022, Pages 490 - 503.
The published version of this article is available at https://dx.doi.org/10.21037/acs-2022-rmvs-21. Copyright © Annals of Cardiothoracic Surgery. All rights reserved.