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Format: 04/24/2014
Format: 04/24/2014

News

Allegheny General Hospital Introduces Minimally Invasive Robotic Mitral Valve Repair Surgery

Tuesday, January 28th, 2014

Allegheny General Hospital’s Cardiovascular Institute recently joined a select group of medical centers in the country performing robotically-assisted minimally invasive mitral valve repair surgery.  The groundbreaking procedure greatly reduces trauma and other health risks and likely helps patients recover more quickly.

“We are extremely excited about the opportunity to expand upon Allegheny General’s advanced expertise in minimally invasive robotic cardiac surgery,” said Walter McGregor, MD, director of the hospital’s robotic cardiac surgery program. “This technology allows us to achieve excellent outcomes when operating on the mitral valve through an almost closed chest procedure.”

Robotic mitral valve surgery performed using the da Vinci Surgical System is done through just a few small incisions on the side of the chest, near the patient’s arm. This approach dramatically reduces trauma to tissue and muscles compared with traditional mitral valve repair surgery, which requires a long incision in the chest wall and a separation of the breastbone at the front of the ribcage. 

The mitral valve controls blood flow through the left side of the heart. When it opens, the mitral valve allows blood to flow into the left ventricle, the heart’s main pumping chamber. The mitral valve closes when the left ventricle contracts to prevent blood from flowing back toward the lungs.

If the mitral valve cannot tightly seal the left ventricle (a condition called prolapse), some blood flows back into the atrium which can make the heart work harder, leading to further valve damage and increasing the risk of heart failure.

Using the da Vinci system, surgeons can treat defective mitral valves as well as those damaged by infection or the aging process by  reconstructing the valve from the patient’s own tissues or replacing it with an artificial valve.

Robotic-assisted mitral valve repair is the latest addition to Allegheny General’s robotic heart surgery program, which launched in May 2012 and was the only one of its kind in Pittsburgh.

Originally developed by NASA for operating remotely on astronauts in space and developed with the Department of Defense to operate on soldiers in the battlefield, the da Vinci System is comprised of two primary components, a remote console that accommodates the surgeon and a five armed robot that is positioned at the patient’s side. 

Sitting comfortably at the console several feet away from the operating room table, the surgeon maneuvers da Vinci's robotic arms and views the surgical field through a high resolution, three dimensional endoscopic camera mounted on one of them.  The System seamlessly and precisely translates the surgeon’s natural hand, wrist and finger movements from controls at the console to the robotic surgical instruments inside the body.

“Patients undergoing robotic mitral valve repair generally experience less scarring, shorter hospital stays, reduced blood loss and a quicker recovery,” Dr. McGregor said.   

Robotic heart surgery continues a long-legacy of pioneering advancements at AGH in the fields of cardiology and cardiovascular surgery.  In the 1990s, cardiac surgeons at the hospital were among the nation’s first to perform the earliest generation of minimally invasive “keyhole” heart bypass procedures.   

In recent years, surgeons at Allegheny became the first in the region to perform minimally invasive Transcatheter Aortic Valve Replacement (TAVR) through the femoral artery as well as a transapical approach directly through the chest wall to treat patients with severely damaged aortic valves.
AGH recently unveiled a $7 million state-of-the-art hybrid operating room that puts unprecedented imaging capabilities within reach of surgical teams, greatly improving their ability to perform highly complex cardiovascular procedures.

Over the past decade, AGH has also developed one of the state’s leading robotic surgery programs, providing patients with less invasive surgical options for a host of medical problems.  The hospital’s kidney transplant team is among a short list of leading medical centers in the country using robotic surgery to less invasively remove kidneys from live donors, and its urologic and gynecologic surgeons have been longtime leaders in robotic assisted laparoscopic techniques.

“The adoption of da Vinci robotic technology for mitral valve surgery evidences Allegheny General’s commitment to maximizing the potential of this sophisticated tool and continually forging toward improved techniques and outcomes,” Dr. McGregor said.

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