ISMICS 2024 Annual Meeting

Is Re-Operative Robotic Assisted Cardiac Surgery Feasible and Safe? A Propensity Matched Analysis

Christophe Hansen-Estruch, MD; Clifton T. Lewis, MD; Kenneth Holt, MD; James L. West, MD; Rongbing Xie, DrPH, MPH; Katherine F. Cornelius, RN, BSN; James E. Davies, MD; Panos N. Vardas, MD

•Robotic-assisted approach to primary valvular operations established as non-inferior with benefits including improved wound complication and return to function1,2

•Reoperative cardiac surgery associated with increased morbidity and mortality

•Robotic-assisted approach viable and reproducible by experienced surgeons3–5

•In light of the increased technical demands, does a robotic assisted approach to reoperative cardiac surgery provide non-inferior clinical outcomes to resternotomy?

Queried Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD) from 2 affiliated institutions Inclusion criteria

•Adults (age > 18) with prior sternotomy for cardiac surgery from 2014-2024

•Operative intervention for structural operations (mitral or tricuspid valve, ASD, etc)

Exclusion criteria

•Patients whose operation included redo CABG, adult congenital, or aortic procedure

Propensity Score Matching (PSM)

•Significant preoperative variables chosen via logistic regression with entry p = 0.20 and stay p = 0.05

•Robotic and open cases matched into 1:3 pairs if absolute difference between scores was ≤ 0.005.

Comparative Statistical Analysis

•Wilcoxon Two-Sample Test for continuous variables

•Chi-square or Fisher’s Exact Test for categorical variables

•Patients undergoing robotic structural heart operations tend to be older and have more co-morbidities than those undergoing resternotomy

•PSM subject to potential confounders not in match

•Robotic approach to valvular operations in a reoperative field can provide non-inferior outcomes to resternotomy

ISMICS 2024 Annual Meeting

Is Re-operative Robotic Assisted Surgery Feasible And Safe? A Propensity Matched Analysis

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