Modified Left Atrial Closure Technique Using Barbed Sutures in Robotic Cardiac Surgery: A Single‐Center Retrospective Cohort Study

Background: Reducing operative times and standardizing surgical techniques are important in robot‐assisted cardiac surgery. We have implemented V‐Loc barbed sutures as a technical refinement to left atrial closure and report our outcomes. Methods: We retrospectively analyzed 45 consecutive patients who underwent robot‐assisted mitral valve repair between January 2023 and September 2024 at Nagoya University Hospital. Patients were divided into two groups: a V‐Loc group ( n = 29) and a conventional suture group ( n = 16). The primary endpoint was left atrial closure time. Secondary endpoints included perioperative complication and reoperation rates. Results: The V‐Loc group demonstrated a shorter left atrial closure time (11 [7.8–13] minutes vs. 16 [14.5–19] minutes in the conventional group, p < 0.01), representing a 31.3% reduction. One patient in the V‐Loc group required reoperation due to intercostal vessel bleeding, unrelated to the closure technique. No operative mortality or major complications were encountered in either group. During a median follow‐up period of 16 months (up to 27 months), no complications associated with the atrial closure technique were observed. Conclusions: The use of V‐Loc barbed sutures for left atrial closure in robot‐assisted mitral valve surgery significantly reduced operative times while maintaining procedural safety. This technique represents a promising approach for standardizing and streamlining robotic cardiac procedures.