This is not an easy question to answer. What I tell patients is that my series and most large published series of robotic mitral valve repairs from high quality centers show a similar or even lower stroke risk with robotic mitral valve repair compared to large open series including the Society of Thoracic Surgeon’s (STS) Database. There was one study by Dr. Gammie from University of Maryland looking at minimally invasive and robotic mitral repair versus open surgery in the STS Database and found a higher risk of stroke with minimally invasive approaches. The problem with that study is it including many surgeons doing low volumes of surgery both open and minimally invasive and therefore may not be representative of higher volume surgeons.
Additionally, we get a CT scan (so called “cat scan”) of the chest, abdomen, pelvis and blood vessels to ensure there is not atherosclerotic disease that might lead to stroke during use of the leg vessels for the heart lung machine. Those of us who get these routinely feel strongly that this will reduce the risk of stroke.
This is a complicated but important question. My basic answer to most patients is that the stroke risk is about the same no matter how the surgery is performed.