Robotic mitral valve repair for rheumatic mitral stenosis and regurgitation: a case report

Eur Heart J Case Rep. 2020 Feb 7;4(1):1-6. doi: 10.1093/ehjcr/ytz240. eCollection 2020 Feb.

Abstract

Background: Rheumatic mitral valve (MV) disease is the major cause of congestive cardiac failure in children and young adults, particularly in developing countries. Mitral valve repair with minimum prosthetic material is the gold standard treatment for this condition. However, MV repair for rheumatic MV disease is known to be technically demanding.

Case summary: A 27-year-old woman without a history of cardiac disease presented with dyspnoea on exertion. Echocardiography revealed rheumatic severe mitral stenosis and regurgitation, with thickening of the bileaflets, doming of the anterior leaflet, shortening of the posterior leaflet, fusions of the lateral and particularly the medial commissure, and enlargement of the mitral annulus. We successfully performed robot-assisted MV repair with bicommissural release, patch augmentation of the two leaflets, and implantation of an originally sized partial band.

Discussion: Robotic MV repair can contribute to precise valve inspection and operative procedures. This approach seems feasible for complex rheumatic MV disease particularly in young patients.

Keywords: Case report; Mitral valve repair; Rheumatic heart disease; Rheumatic mitral regurgitation; Rheumatic mitral stenosis; Robotic mitral valve repair; Robotic surgery.

Publication types

  • Case Reports