Author(s)

Zhilian Huang ¹, Haiyan Li ¹, Zhaoming Lin ², Xiaoshen Zhang ²

Affiliation(s)

¹ Operating Room, The First Affiliated Hospital of Jinan University, Guangzhou, China
² Department of Cardiovascular Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China

Corresponding Author

Xiaoshen Zhang

ABSTRACT

This study aimed to summarize the clinical experience and evaluate the feasibility, perioperative management, and early outcomes of robot-assisted minimally invasive cardiac surgery in patients with structural heart disease. In this retrospective single-center case series, ten consecutive patients (six women and four men; median age 47.5 years, range 23–58 years) with structural heart disease—including mitral valve disease (n=7), tricuspid valve disease (n=1), atrial or atrioventricular septal defect (n=2), and mixed valvular disease—underwent robot-assisted thoracoscopic cardiac surgery between March and April 2026. All procedures were successfully completed under cardiopulmonary bypass without conversion to median sternotomy; notably, one operation was performed as a cross-border remote live-broadcast surgery between Guangzhou and Chinese Macau. Surgical procedures comprised mitral valve replacement or repair, tricuspid valve repair, atrial septal defect repair, atrioventricular septal defect repair, and patent foramen ovale closure. No perioperative mortality occurred. All patients required postoperative mechanical ventilation and vasoactive support, while two patients (20%) required intra-aortic balloon pump support due to low cardiac output syndrome. Postoperative inflammatory responses and electrolyte disturbances were observed in all patients, and coagulation dysfunction and hematologic abnormalities were also common. Several high-risk patients developed postoperative complications, including infection, hepatic dysfunction, pleural complications, and prolonged intensive care unit stay; nevertheless, all patients survived to discharge or showed clinical improvement during hospitalization. Follow-up echocardiography demonstrated satisfactory valve function and successful defect closure in most patients. In conclusion, robot-assisted minimally invasive cardiac surgery is feasible and safe in selected patients with structural heart disease, including those with complex valvular and congenital lesions, and favorable short-term outcomes can be achieved with comprehensive perioperative management, although postoperative systemic complications remain relatively common in high-risk patients.

KEYWORDS

Robot-assisted cardiac surgery; minimally invasive surgery; structural heart disease; perioperative management; valve surgery; case series

CITE THIS PAPER

Zhilian Huang, Haiyan Li, Zhaoming Lin, Xiaoshen Zhang. Clinical Experience of Robot-Assisted Minimally Invasive Cardiac Surgery and Perioperative Management in Patients with Structural Heart Disease: A Single-Center Case Series. MEDS Clinical Medicine (2026). Vol. 7, No.2, 119-127. DOI: http://dx.doi.org/10.23977/medsc.2026.070215.

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