Robotic Surgery

Mitral valve regurgitation occurs when the heart's mitral valve leaflets do not come together, allowing blood to leak backward when the left ventricle squeezes. If you have mitral valve regurgitation, the best treatment is to repair the valve. Repairing the valve, rather than replacing it, is associated with better survival and heart function for our patients. In most hospitals, this surgery is usually performed by opening the chest through the breastbone, or sternum. At Emory, most of our mitral valve repairs are done using minimally invasive procedures, including robotic mitral valve surgery and percutaneous mitral valve clip placement.

The Emory Heart and Vascular Center's Robotic Cardiac Surgery program offers patients progressive surgery options with shorter recovery, lower complication rates and greater success when compared to conventional cardiac surgery.

• Volume: Only 7% of the mitral valve surgery in the United States is being done robotically due to the significant time commitment required to learn the technology. At Emory, experienced surgeons perform an average of 20 robotic mitral valve surgeries a month and over 300 robotic cardiac surgeries every year.
• Shorter Recovery: With the conventional sternotomy, recovery takes two to three months. Robotic cardiac surgery results in fast recovery, around two weeks, as the patient's chest skeleton isn't disturbed. Patients agree to surgical mitral valve repair earlier when they realize they can get back to work after two weeks.
• Improved Valve Repair Success Rates: Improved visualization of valves through the robot and the ability to perform complex repair techniques have increased repair rates to over 90%.
• Fewer Complications: Approximately 2,700 robotic surgeries have been done at Emory without a single incidence of chest wound infection. There is typically a higher infection risk post-sternotomy.
• Referral Center: Patients from throughout the U.S. travel to Emory for robotic mitral valve repair. They arrive two days before surgery, are typically discharged from the hospital after four days and are asked to stay in Atlanta for a few days before they return to their hometown.
• Simultaneous Treatment of Multiple Conditions: Multiple procedures can be performed during one robotic cardiac surgery. These may include repair or replacement of the mitral and/or tricuspid valve, atrial fibrillation ablation, atrial septal defect/ventricular septal defect or other congenital repairs, coronary artery bypass, excision of benign tumors, or closing the left atrial appendage.
• Complex Cases: Technically difficult patients who cannot be easily operated on by hand because of their size or complex anatomy are candidates for robotic cardiac surgery.

Emory's expert robotic heart surgery teams include surgeons, anesthesiologists, surgical assistants, nurses, perfusionists, and technicians. Unlike traditional approaches to heart surgery, which require opening the chest, robotic surgery is performed with small holes (<1 inch), which do not affect the ribs or disrupt the skeleton.

Robotic ports are placed in these small incisions, which allow robotic arms to be controlled by the surgeon from the console. The robotic camera provides high-definition, 3D visualization, and the robotic arms allow for 3D movements inside the heart. The surgical assistant is then able to pass sutures and other instruments through one of these small holes to enable all maneuvers necessary to repair or replace the mitral valve.

Through an additional 3-inch incision in either the groin or chest, we use the arteries and veins to place patients on the heart lung machine, which is necessary for operations inside of the heart and to protect the heart. When surgery is complete, most patients are taken off the ventilator before transfer to the intensive care unit. Typically the stay in the ICU is short and the patient is discharged two to three days after surgery and back to normal activity weeks.

In percutaneous mitral valve clip placement, a catheter (thin, flexible tube) is used to deliver a small clip into the heart via the femoral vein. Once in place, the clip is attached to the leaflets of the mitral valve to improve their function, and the catheter is removed. Since the procedure is minimally invasive, the recovery time is substantially shorter than with open-heart surgery, the traditional method for treating mitral valve leaks.