Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest
Abstract Background Minimally invasive cardiac surgery for mitral regurgitation is challenging in patients with narrow chests due to limited thoracic space. The butterfly technique can prevent systolic anterior motion in patients with degenerative mitral regurgitation and redundant posterior leaflet...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03275-9 |
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| _version_ | 1841559175786659840 |
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| author | Suguru Tatsuki Makoto Hashimoto Ryuji Koshima |
| author_facet | Suguru Tatsuki Makoto Hashimoto Ryuji Koshima |
| author_sort | Suguru Tatsuki |
| collection | DOAJ |
| description | Abstract Background Minimally invasive cardiac surgery for mitral regurgitation is challenging in patients with narrow chests due to limited thoracic space. The butterfly technique can prevent systolic anterior motion in patients with degenerative mitral regurgitation and redundant posterior leaflets, but it is difficult to perform via minimally invasive cardiac surgery. Few reports have described mitral valve repair using the butterfly technique or in a narrow chest. This case report demonstrates the feasibility and utility of robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest, addressing the challenges involved through innovative port insertion and visualization. Case presentation A 70-year-old woman with a narrow chest (58 mm from spine to sternum) presented with shortness of breath on exertion. Transesophageal echocardiography revealed severe mitral regurgitation with posterior leaflet prolapse. Robotically assisted mitral valve repair was performed. Skin incisions were made in the third, fourth, and sixth intercostal spaces on the right anterior axillary line. A port for the atrial retractor was placed slightly medial to the right mid-clavicular line in the fifth intercostal space, inserted more shallowly than usual to achieve mitral valve exposure. The P2 leaflet was resected and reconstructed using the butterfly technique, followed by mitral annuloplasty with a semirigid partial band. The patient was discharged 6 days postoperatively with excellent valve function. One year later, she remained asymptomatic without obvious mitral regurgitation. Conclusions Robotically assisted mitral valve repair using the butterfly technique is feasible in patients with narrow chests. Robotic assistance facilitates mitral valve exposure and manipulation in challenging anatomical conditions through enhanced dexterity and visualization. |
| format | Article |
| id | doaj-art-d4a392b57c4b464ea85792f7a5c72296 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-d4a392b57c4b464ea85792f7a5c722962025-01-05T12:45:38ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-012011510.1186/s13019-024-03275-9Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chestSuguru Tatsuki0Makoto Hashimoto1Ryuji Koshima2Department of Cardiovascular Surgery, Sapporo Cardio Vascular ClinicDepartment of Cardiovascular Surgery, Sapporo Cardio Vascular ClinicDepartment of Cardiovascular Surgery, Sapporo Cardio Vascular ClinicAbstract Background Minimally invasive cardiac surgery for mitral regurgitation is challenging in patients with narrow chests due to limited thoracic space. The butterfly technique can prevent systolic anterior motion in patients with degenerative mitral regurgitation and redundant posterior leaflets, but it is difficult to perform via minimally invasive cardiac surgery. Few reports have described mitral valve repair using the butterfly technique or in a narrow chest. This case report demonstrates the feasibility and utility of robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest, addressing the challenges involved through innovative port insertion and visualization. Case presentation A 70-year-old woman with a narrow chest (58 mm from spine to sternum) presented with shortness of breath on exertion. Transesophageal echocardiography revealed severe mitral regurgitation with posterior leaflet prolapse. Robotically assisted mitral valve repair was performed. Skin incisions were made in the third, fourth, and sixth intercostal spaces on the right anterior axillary line. A port for the atrial retractor was placed slightly medial to the right mid-clavicular line in the fifth intercostal space, inserted more shallowly than usual to achieve mitral valve exposure. The P2 leaflet was resected and reconstructed using the butterfly technique, followed by mitral annuloplasty with a semirigid partial band. The patient was discharged 6 days postoperatively with excellent valve function. One year later, she remained asymptomatic without obvious mitral regurgitation. Conclusions Robotically assisted mitral valve repair using the butterfly technique is feasible in patients with narrow chests. Robotic assistance facilitates mitral valve exposure and manipulation in challenging anatomical conditions through enhanced dexterity and visualization.https://doi.org/10.1186/s13019-024-03275-9Minimally invasive cardiac surgeryMitral regurgitationMitral valve repairButterfly techniqueNarrow chestRobotically assisted surgery |
| spellingShingle | Suguru Tatsuki Makoto Hashimoto Ryuji Koshima Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest Journal of Cardiothoracic Surgery Minimally invasive cardiac surgery Mitral regurgitation Mitral valve repair Butterfly technique Narrow chest Robotically assisted surgery |
| title | Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest |
| title_full | Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest |
| title_fullStr | Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest |
| title_full_unstemmed | Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest |
| title_short | Robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest |
| title_sort | robotically assisted mitral valve repair using the butterfly technique in a patient with a narrow chest |
| topic | Minimally invasive cardiac surgery Mitral regurgitation Mitral valve repair Butterfly technique Narrow chest Robotically assisted surgery |
| url | https://doi.org/10.1186/s13019-024-03275-9 |
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