Heart Valve Summit Video #7: “Are All Patients Candidates For Robotic Mitral Valve Repair?” Asks EvanPosted by Adam Pick on November 22nd, 2011
A few days before the Heart Valve Summit, Evan sent me a great question that reads, “Adam – Specific to mitral valve repair with a robot… Are all patients candidates for this surgical technique?”
To provide Evan an expert opinion, I discussed this topic with Dr. Harold Roberts, MD, an experienced heart valve surgeon from Aventura Hospital in Florida. Here are the highlights from our discussion. (A transcript of this interview is provided below for those patients and caregivers in our community who are hearing impaired.)
Thanks to Evan for his great question and a special thanks to Dr. Harold Roberts for sharing his clinical expertise with our community. To learn more about Dr. Roberts and his practice, please click here.
Keep on tickin!
P.S. Here is the video transcript of my discussion with Dr. Roberts:
Adam: “Hi everybody, it’s Adam and we are at the Heart Valve Summit. We’re answering your questions that were posted at HeartValveBlog.com. Thrilled to be joined today by Dr. Harold Roberts who practices at the Aventura Hospital in Florida. The question for Dr. Roberts comes in from Evan, and Evan writes: Adam, Specific to mitral valve repair with a robot. Are all patients candidates for this surgical technique?”
Da Vinci Surgical Robot For Mitral Valve Repair
Dr. Harold Roberts: “Well, I think I can say categorically that, no, not all patients are candidates for this type of procedure. However, a large proportion are. But in order to determine if it is indeed in the patient’s best interest to be done through a robotic endoscopic approach, a number of tests have to be carried out. This would include things like cardiac catheterization. Patients have, let’s say, a severely leaky mitral valve that needs to fixed; but it turns out that they also have several blockages in their coronary arteries. Well I don’t think this approach is appropriate, because then those patients would probably be best served by a traditional sternotomy with multiple bypasses and a mitral valve repair at that time. However, if they don’t have significant coronary disease, their left ventricle is fairly strong; you would not want to, because of the additional time required on the heart lung machine. You don’t want to use this approach for patients that have really weak ventricles. Those types of patients are best served by short and sweet, quick operations. However, it is quite a safe way to go for patients who need complex mitral valve repairs. Most patients that have leaky mitral valves, valves can be reliably and securely fixed, reconstructed by this technique. But you would need, number one, to make sure that they do not have significant coronary artery disease. Also don’t want to do patients, through this approach, through the right side approach; either the mini-thoracotomy or robotic endoscopic approach, if they have severely damaged lungs. The reason being, when you go through the right chest it can transiently make the right lung a little sick for a temporary time, maybe a day or two. And if they have marginal lung capacity that type of patient may not tolerate this type of approach.”
Adam: “Great, well Evan I hope that helped you. I know it helped me learn a whole lot more. Dr. Roberts, I know you’ve been practicing now for quite some time in Florida. About how long have you been practicing?”
Dr. Roberts: “I’ve been here since 1990. And I actually started doing mitral repair after spending a week with Alain Carpentier in Paris back in 1992. So I’m going on twenty years of doing this and as you can see by my attendance at this valve summit, it is a passion of mine and I attend these types of conferences on a very regular basis. Probably go to at least 6 or 8 of these a year.”
Adam: “Right. Thank you so much for stopping by and sharing your information, your clinical work and your research with Evan and the rest of us. We really appreciate it and I just want to thank you again.”
Harold Roberts, MD: “All right. Thank you Adam.”