title: A meta-analysis of robotic vs. conventional mitral valve surgery.
abstract: OBJECTIVE
  The present study is the first meta-analysis to compare the surgical outcomes of robotic vs. conventional mitral valve surgery in patients with degenerative mitral valve disease.
  
  
  METHODS
  A systematic review of the literature was conducted to identify all relevant studies with comparative data on robotic vs. conventional mitral valve surgery. Predefined primary endpoints included mortality, stroke and reoperation for bleeding. Secondary endpoints included cross-clamp time, cardiopulmonary bypass time, length of hospitalization and duration of intensive care unit (ICU) stay. Echocardiographic outcomes were assessed when possible.
  
  
  RESULTS
  Six relevant retrospective studies with comparative data for robotic vs. conventional mitral valve surgery were identified from the existing literature. Meta-analysis demonstrated a superior perioperative survival outcome for patients who underwent robotic surgery. Incidences of stroke and reoperation were not statistically different between the two treatment arms. Patients who underwent robotic surgery required a significantly longer period of cardiopulmonary bypass time and cross-clamp time. However, the lengths of hospitalization and ICU stay were not significantly different. Both surgical techniques appeared to achieve satisfactory echocardiographic outcomes in the majority of patients.
  
  
  CONCLUSIONS
  Current evidence on comparative outcomes of robotic vs. conventional mitral surgery is limited, and results of the present meta-analysis should be interpreted with caution due to differing patient characteristics. However, it has been demonstrated that robotic mitral valve surgery can be safely performed by expert surgeons for selected patients. A successful robotic program is dependent on a specially trained team and a sufficient volume of referrals to attain and maintain safety.
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Christopher
authors: C
authors: Cao
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Hugh
authors: H
authors: Wolfenden
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Kevin
authors: K
authors: Liou
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Faraz
authors: F
authors: Pathan
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Sunil
authors: S
authors: Gupta
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Thomas A
authors: TA
authors: Nienaber
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: David
authors: D
authors: Chandrakumar
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Praveen
authors: P
authors: Indraratna
authors: 1 The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; 2 Department of Cardiothoracic Surgery, 3 Department of Cardiology, Prince of Wales Hospital, Sydney, Australia ; 4 The Royal Prince Alfred Hospital, Sydney University, Sydney, Australia.
authors: Tristan D
authors: TD
authors: Yan
keywords: Mini-mitral; meta-analysis; mitral valve; robotic surgery