Robot-Assisted Mitral and Tricuspid Valve Repair
1. What are Mitral Valve Regurgitation and Tricuspid Valve Regurgitation?
2. Details of Robot-Assisted Surgery
3. Strengths of Robot-Assisted Surgery at St. Luke’s International Hospital
3-1. Comprehensive Team Support System
3-2. Low-Barrier Interdepartmental Collaboration
3-3. Safe, Secure, and Comfortable Recovery Environment with All Private Rooms
1. What are Mitral Valve Regurgitation and Tricuspid Valve Regurgitation?
The heart functions as a pump that sends blood throughout the body and is divided into four chambers. The two on the right are called the right atrium and right ventricle, while the two on the left are called the left atrium and left ventricle. Each chamber is separated by valves. Blood returning from the body passes through the tricuspid valve from the right atrium to the right ventricle, which then pumps it to the lungs. Oxygenated blood from the lungs is sent to the left atrium, passes through the mitral valve to the left ventricle, which plays the central role in pumping blood throughout the body. The tricuspid and mitral valves are parachute-shaped and anchored to the ventricles by numerous cord-like tissues called chordae tendineae. These ensure that the mitral and tricuspid valves close completely when the ventricles contract to pump blood, preventing backflow. If these chordae tendineae are stretched or broken, the valves cannot close completely when the heart contracts, resulting in regurgitation. This condition is known as mitral valve regurgitation or tricuspid valve regurgitation. As this condition progresses, it can lead to heart failure. While medications such as diuretics can temporarily alleviate symptoms, they cannot stop the progression of the disease, leading to repeated episodes of heart failure and gradual worsening.
2. Details of Robot-Assisted Surgery
The surgery is performed under general anesthesia. To support the heart and lungs, catheters are inserted into blood vessels in the groin (inguinal region) or neck to connect to a heart-lung machine, which removes venous blood, adds oxygen, and returns it to the arteries. Robot-assisted surgery does not mean the robot performs the surgery. In conventional surgery, the surgeon directly holds the surgical instruments, whereas in robot-assisted surgery, robotic arms hold the instruments, and the surgeon operates the robot to perform the surgery. In robot-assisted surgery, a main 2-4 cm incision is made on the right side of the chest, along with 3-4 small holes for inserting and removing instruments. Thin robotic arms are inserted through these openings. Unlike conventional surgery, this results in smaller incisions. Additionally, since no bones need to be cut, it is expected to prevent post-operative physical weakness, reduce pain, and allow for earlier discharge and quicker return to normal activities. Our hospital has been using this technique since 2019 when it became covered by insurance.
Valve repair surgery is a procedure to repair your own valve. Using your own valve has the advantage of better cardiac function and lower risk of infection. Another benefit is that warfarin, a blood-thinning medication, only needs to be taken for a few months after surgery to prevent blood clots. Repair is the primary approach for mitral valves, with over 90% of mitral valve regurgitation cases being repairable. The same applies to tricuspid valves. However, if the valve degeneration is severe or repair is difficult, there is a possibility of switching to artificial valve replacement.
3. Strengths of Robot-Assisted Surgery at St. Luke’s International Hospital
3-1. Comprehensive Team Support System
A heart team consisting of echocardiography specialists, cardiovascular surgeons, anesthesiologists, nurses, physical therapists (rehabilitation), clinical engineers, and administrative staff provides optimal treatment for patients. In addition to maintaining a high standard of medical treatment, all multidisciplinary staff, including nurses and physical therapists, function at a high level, providing comprehensive support from pre-operative care through post-operative rehabilitation and outpatient follow-up.
3-2. Low-Barrier Interdepartmental Collaboration
Management of comorbidities is essential when treating high-risk surgical patients. Our hospital has many specialized departments and emphasizes interdepartmental collaboration, allowing patients to receive specialized support for conditions beyond cardiac diseases with peace of mind.
3-3. Safe, Secure, and Comfortable Recovery Environment with All Private Rooms
If post-operative progress is favorable, patients can be moved to the general ward the day after surgery to focus on rehabilitation (*This depends on individual patient progress). All general wards in our hospital are private rooms, allowing patients to relax in a quiet environment and concentrate on post-operative recovery. This not only ensures privacy but also reduces the risk of infection from other patients, providing a safe and secure environment.
