title: The use of the mini-cardiopulmonary bypass circuit in robotic mitral valve surgery.
abstract: BACKGROUND
  : Computer enabled robotic mitral valve repair cases have longer cross-clamp and perfusion times because of the more technically difficult procedure. To modify some of the well-documented side effects of standard cardiopulmonary bypass (CPB), we used a new mini-circuit on three robotic mitral cases.
  
  
  METHODS
  : Three patients having mitral valve repair (triangular resection of P2 and annuloplasty ring) using the daVinci Robot (Intuitive Surgical, Sunnyvale, CA) had circulatory support using a modified Resting Heart System (Medtronic, Inc., Fridley, MN), a vertically oriented space saving CPB configuration incorporating a high efficiency miniaturized oxygenator, centrifugal pump, shortened heparin coated tubing and an air evacuation system with a closed circuit.
  
  
  RESULTS
  : All patients had successful mitral repair (echo = 0 to trace residual leakage) under a cross-clamp time of 161 ± 54 minutes and perfusion time of 229 ± 31 minutes. No blood was given during CPB and 0.7 ± 1.2 red cell units after the CPB run and 0.7 ± 1.2 units during the postoperative course.
  
  
  CONCLUSIONS
  : Miniaturized bypass circuit reducing the level of necessary anticoagulation, hemodilation, and blood trauma can be used despite the increased perfusion time necessary for robotic mitral surgery.
authors.affiliation: From the Divisions of Cardiovascular Surgery, Regions and St. Joseph's Hospitals, St. Paul, Minnesota.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Emery
authors.forename: Goya V
authors.initials: GV
authors.lastname: Raikar
authors.forename: Barbara
authors.initials: B
authors.lastname: Murphy
authors.forename: Anton
authors.initials: A
authors.lastname: Rohan
authors.forename: Kris
authors.initials: K
authors.lastname: Nielsen