Background: Computer enabled robotic mitral valve repair cases have longer cross-clamp and perfusion times because of the more technically difficult procedure. To modify some of the well-documented side effects of standard cardiopulmonary bypass (CPB), we used a new mini-circuit on three robotic mitral cases.
Methods: Three patients having mitral valve repair (triangular resection of P2 and annuloplasty ring) using the daVinci Robot (Intuitive Surgical, Sunnyvale, CA) had circulatory support using a modified Resting Heart System (Medtronic, Inc., Fridley, MN), a vertically oriented space saving CPB configuration incorporating a high efficiency miniaturized oxygenator, centrifugal pump, shortened heparin coated tubing and an air evacuation system with a closed circuit.
Results: All patients had successful mitral repair (echo = 0 to trace residual leakage) under a cross-clamp time of 161 +/- 54 minutes and perfusion time of 229 +/- 31 minutes. No blood was given during CPB and 0.7 +/- 1.2 red cell units after the CPB run and 0.7 +/- 1.2 units during the postoperative course.
Conclusion: Miniaturized bypass circuit reducing the level of necessary anticoagulation, hemodilation, and blood trauma can be used despite the increased perfusion time necessary for robotic mitral surgery.