Robotic surgery a “draw” for heart valve repair 

When Debbie learned she needed surgery to repair her heart’s leaky mitral valve, she wanted it done easily and quickly.

“I wanted it to be like having a tooth pulled. I needed it to be that quick and easy,” said the Bridgeport-area resident and businesswoman.

She specifically wanted robotic surgery, which typically means less pain, a shorter hospital stay and quicker recovery. When Debbie found it was an option at Yale New Haven Hospital’s Heart and Vascular Center, she made an appointment with Arnar Geirsson, MD, chief of Cardiac Surgery. Robotic surgery was “the draw,” she said. “In my mind I was going to bounce back.”

Last October, YNHH became the only New England hospital to offer robotic-assisted mitral valve repair; and the number of patients having this surgery has grown steadily since. Performed with the da Vinci Xi® robotic surgical system, the procedure typically requires only five one-inch incisions, which can mean less bleeding, lower risk of infection and no splitting of the breast bone.

“This procedure offers very advanced treatment of mitral valve disease using cutting-edge techniques, from which the patient can recover very quickly,” Dr. Geirsson said. “That allows for fast return to normal activities.”

The mitral valve is one of four valves in the heart that help keep blood moving in the right direction. As the heart beats, the mitral valve opens to let blood flow from the left atrium into the left ventricle, then closes to prevent blood from seeping back. Mitral valve diseases include stenosis, when the valve narrows; mitral valve regurgitation, when blood leaks from the valve back into the left atrium; and mitral valve prolapse, when the valve’s flaps bulge instead of closing completely, which can result in regurgitation.

About six years ago, after numerous episodes of palpitation, Debbie learned from her cardiologist, Linda Casale, MD, of Northeast Medical Group, that she had mitral valve prolapse. The condition affects about 2 percent of the population, but in many cases doesn’t cause symptoms or affect a person’s health. When symptoms do occur, they can include palpitations, shortness of breath, swelling and endocarditis (infection of the lining of the heart chambers and valves). Surgical repair should be considered if symptoms start or the leak has become severe, Dr. Geirsson said.

During Debbie’s first visit with Dr. Geirsson in fall 2018, he and Maureen Legenos, RN, nurse coordinator for the cardiac surgery valve program, explained the robotic-assisted mitral valve repair procedure. Debbie was also provided with a “coach,” a patient who previously had the procedure.

Debbie underwent surgery in December 2018, was discharged after two and a half days and back to work in two weeks.

“It was so amazing,” she said of her experience. “I felt like a million bucks. I had no trouble at all. No pain. No discomfort whatsoever.”

Robotic-assisted surgery is one of a number of mitral valve repair procedures available through YNHH’s Heart and Vascular Center. Others include minimally invasive mitral valve surgery for patients who are not candidates for robotic surgery; mitral valve surgery with other heart procedures such as coronary artery bypass or aortic valve replacement; MitraClip®, a device that improves certain types of mitral valve leakage; and transcatheter mitral valve replacement.