title: Quality of life after early mitral valve repair using conventional and robotic approaches.
abstract: BACKGROUND
  Early mitral valve (MV) repair of degenerative mitral regurgitation is associated with superior clinical outcomes compared with prosthetic replacement and restores normal life expectancy, even in those without symptoms. Although current guidelines recommend prompt referral for effective MV repair in those with severe mitral regurgitation, some are reluctant to pursue early correction due to the perception that short-term quality of life (QOL) may be adversely affected by the operation.
  
  
  METHODS
  Between January 2008 and November 2009, 202 patients underwent conventional transsternotomy or minimally invasive port-access robot-assisted MV repair, with or without patent foramen ovale closure or left Maze, and were mailed a postsurgical QOL survey.
  
  
  RESULTS
  Unadjusted QOL scores for patients undergoing MV repair were excellent early after the operation using both approaches. Robotic repair was associated with slightly improved scores on the Duke Activity Status Index, the Short Form-12 Item Health Survey Physical domain, and the Linear Analogue Self-Assessment frequency of chest pain and fatigue indices during the first postoperative year; however, differences between treatment groups became indistinguishable after 1 year. Robotic repair patients returned to work slightly quicker (median, 33 vs 54 days, p<0.001).
  
  
  CONCLUSIONS
  Functional QOL outcomes within the first 2 years after early MV repair are excellent using open and robotic platforms. A robotic approach may be associated with slightly improved early QOL and return to employment-based activities. These results may have implications regarding future evolution of clinical guidelines and economic health care policy.
authors.affiliation: Division of Cardiovascular Surgery, Mayo Medical School, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905, USA. suri.rakesh@mayo.edu
authors.forename: Rakesh M
authors.initials: RM
authors.lastname: Suri
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Antiel
authors.forename: Harold M
authors.initials: HM
authors.lastname: Burkhart
authors.forename: Marianne
authors.initials: M
authors.lastname: Huebner
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Li
authors.forename: David T
authors.initials: DT
authors.lastname: Eton
authors.forename: Tali
authors.initials: T
authors.lastname: Topilsky
authors.forename: Maurice E
authors.initials: ME
authors.lastname: Sarano
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D012371:Robotics