MP61. Shortening the Learning Curve in Robotic Mitral Valve Surgery: The Importance of Mentorship
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Dr. Shah was born and raised in New York and completed medical school at Duke University. While there, he was awarded a Doris Duke Research Fellowship which allowed him to spend a year at Yale University School of Medicine conducting research. He continued his surgical residency and cardiothoracic surgery fellowship at Duke University. Practicing adult cardiac surgery in Orange County, Dr. Shah is a founding member of the medical group, Newport Cardiac & Thoracic Surgery. He is currently the Chair of Cardiac & Thoracic Surgery and Director of Robotic Cardiac Surgery at Hoag Memorial Hospital Presbyterian.
Dr. Shah’s clinical interests include thoracic aortic disease, minimally invasive valve surgery, coronary artery bypass grafting, robotic cardiac surgery, and transcatheter therapies, including TAVR and TEVAR. Dr. Shah has conducted extensive research in cardiovascular surgery including studying the genetics of thoracic aortic aneurysms and bicuspid aortic valve syndrome. He has over 40 peer-reviewed publications and has given over 20 national presentations. He has been an invited speaker for the Society of Thoracic Surgeons on multiple occasions and has received numerous academic and research awards from organizations including the American Association of Thoracic Surgery and the Joint Council on Thoracic Surgical Education.
Description
Methods: The required Intuitive training courses were completed, and two cases performed by the mentor were observed. The mentor was present for 8 of the first 10 cases performed by the primary surgeon; thereafter, mentorship continued virtually on an as-needed basis (Table 1). STS data on all robotic mitral valve surgeries performed by a single surgeon between 10/2020-12/2022 was retrospectively reviewed.
Results: Of 46 robotic cardiac operations performed during the study period, 20 were mitral valve repairs and 4 were planned mitral valve replacements. There were no operative or late mortalities, strokes, renal failures, reoperations for bleeding, or prolonged ventilations. One patient required conversion to sternotomy and also cauterization of a liver injury. Median length of hospital stay was 4 days. There was one readmission. For the 20 mitral repair patients, 13 had no MR at and 7 had trace MR during follow-up.
Conclusions: In this single-center descriptive report, with close mentorship from an experienced robotic surgeon, learning to perform robotic mitral valve surgery independently with excellent outcomes can be accomplished in a much shorter timeframe than traditionally considered.