• Max Shin, Jonathan J Szeto, Chase Brown, Omar Toubat, Mark R Helmers, Amit Iyengar, Michael A Acker, Arnar Geirsson, Robert L Smith, and Michael E Ibrahim.
• Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pa.
• J. Thorac. Cardiovasc. Surg. 2024 Oct 8.

BackgroundDespite numerous reported benefits of robotic mitral repair, the absolute number of procedures performed remain low in part to uncertainties about the necessary steps to launch a program. In this report, we describe our early outcomes and strategy with launching a successful new robotic mitral repair program.MethodsOur multimodal strategic plan emphasized team education, hands-on technical preparation, stepwise advancement, and careful patient selection. Consultant service analytics and team debriefings allowed for iterative improvements.ResultsBetween March 2022 and February 2024, 50 patients underwent robotic mitral repair at our institution. Average age at time of operation was 62 years with a Society of Thoracic Surgeons risk score of 0.58. Successful repairs were performed in 98% of patients. There was 1 conversion to sternotomy. There were no deaths, and there was minimal perioperative morbidity. On both predischarge and follow-up echocardiography, no patients had greater than mild mitral regurgitation.ConclusionsOur work provides a model for establishing a successful robotic mitral program. An up-front emphasis on team education, careful preparation, proper patient selection, and feedback-driven improvements can accelerate the attainment of standards set by high-volume centers.Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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