I have been doing roughly 100 robotic mitral valve repairs or similar procedures per year for many years which only a small handful of surgeons in the United States perform at that volume. I also do a lot of standard open heart surgical procedures. My expectation is that as more and more patients realize they don’t need to undergo sternotomy (breast plate divided) to have their mitral valve repaired, our volume will grow very high levels. That will be up to those I work for-the patients! If every patient in the was fully informed about this option my guess if most of them would want robotic endoscopic surgery. The problem is that many don’t know about it or are misinformed about it. Many cardiologist don’t have a good understanding of the capabilities of a high volume, high performance robotic cardiac surgery center versus surgical teams that either tried and abandoned the technique due to its complexity or who do it in low volumes.

My mitral valve repair rate is roughly 98%. Its rare for me to replace a valve unless the valve is severely damaged by rheumatic disease or if a previous replacement valve needs to be re-replaced. Of course, nothing is 100% and on rare occasions we do have repairs that are not successful. Any surgeon who tells you different is not being truthful. That being said, with mitral valve prolapse, you can expect a 95-99% chance of repair and a 90% chance of a durable repair based on my experience. Again, anyone who tells you that there is no chance of failure is simply not being honest with you. However, if you go to someone like me who does a high volume of repair surgery, your odds of a successful and durable repair are much greater than if you go to a low volume, low repair rate surgeon. The literature supports this.

Category: Questions About Preoperative Issues
T. Sloane Guy, MD

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