{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:30Z","timestamp":1787018070960,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2015,11,24]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Severe primary (degenerative) mitral regurgitation (MR) is repaired with durable results when simple single-scallop disease is addressed. The midterm quality outcomes of minimally invasive repair for complex disease are unknown, however.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      From January 2008 to January 2015, 487 patients (56\u00b111 years, 360 men, ejection fraction 65\u00b16%, 98.8% complete follow-up) underwent robotic mitral valve repair for severe nonischemic degenerative MR. Simple pathology was addressed in 289 of 487 (59%) patients, and complex repair (all others) was performed in 198 of 487 (41%). Four patients died during follow-up with a 5-year survival rate 99.5% (99.4% simple; 99.5% complex; hazard ratio, 0.48; 95% confidence interval, 0.05\u20134.59); and New York Heart Association functional class I\/II was documented in 97.9% (477\/487). Eight patients had recurrence of moderate-to-severe MR (4 simple, 4 complex), with a 5-year freedom from MR of 94.6% (96.2% simple; 92.7%, complex;\n                      <jats:italic>P<\/jats:italic>\n                      =0.67; hazard ratio, 1.36; 95% confidence interval, 0.34\u20135.43). Seven patients (2 simple, 5 complex), underwent mitral reoperation, with a 5-year freedom from reoperation of 97.7% (99.1% simple; 95.7% complex;\n                      <jats:italic>P<\/jats:italic>\n                      =0.13; hazard ratio, 3.35; 95% confidence interval, 0.65\u201317.32).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>At a large tertiary care referral center, midterm quality outcomes after robotic correction of degenerative MR are excellent, with very high survival, infrequent complications, and a low likelihood of MR recurrence, regardless of mitral valve repair complexity. Awareness of these improvements in outcome is important to inform contemporary decisions regarding high-quality alternatives to conventional and percutaneous mitral repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.115.017792","type":"journal-article","created":{"date-parts":[[2015,10,20]],"date-time":"2015-10-20T00:34:18Z","timestamp":1445301258000},"page":"1961-1968","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":83,"title":["Robotic Mitral Valve Repair for Simple and Complex Degenerative Disease"],"prefix":"10.1161","volume":"132","author":[{"given":"Rakesh M.","family":"Suri","sequence":"first","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Taggarse","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold M.","family":"Burkhart","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C.","family":"Daly","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Mauermann","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick A.","family":"Nishimura","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo","family":"Li","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Dearani","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector I.","family":"Michelena","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Enriquez-Sarano","sequence":"additional","affiliation":[{"name":"From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, 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