Early Results of Robotically Assisted Congenital Cardiac Surgery: Analysis of 242 Patients.

Abstract

Robotic surgery is an alternative to traditional and minimally invasive cardiac procedures. The adaption of robotics in congenital cardiac surgery has remained limited, however. We analyzed the early outcomes of our single-center experience in robotically assisted congenital cardiac surgery. From May 2013 to February 2020, 242 robotic operations were done for secundum atrial septal defects (74.7%), sinus venous atrial septal defects (16.1%), partial anomalous pulmonary venous connections (10.7%), widely patent foramen ovale (3.7%), ostium primum defects (2.5%), unroofed coronary sinus (1.2%), partial atrioventricular canal defects (2.5%), residual septal defects after failed percutaneous closure (1.2%), ventricular septal defect (0.4%), cor triatriatum sinister (0.4%), subvalvular aortic stenosis (0.4%), common atrium (0.4%), and double-chambered right ventricle (0.4%) using the da Vinci system. There was no mortality. Mean age was 30.9 ± 12.1 years, and 132 (54.5%) patients were female. Thirty (12.3%) patients were pediatric (median, 16 years; range, 12-17 years). Mean cardiopulmonary bypass and aortic clamping times were 89.5 ± 30.0 and 44.9 ± 22.3 minutes, respectively. We noted a steady decrease in operation times during the first year. Conversion to larger thoracic incisions was needed in 2 (0.8%) patients. The postoperative rates of stroke, cardiac events, pulmonary complications, and reexploration were 0.4%, 2.4%, 4.1%, and 0.8%, respectively. Mean hospital stay was 3.5 ± 1.1 days. Robotic technology can be utilized to perform suitable congenital cardiac procedures safely and effectively. With acceptable complication rates, robotic surgery can be an alternative to traditional, minimally invasive, and endoscopic approaches in adolescent and adult patients.