Longitudinal quality of life assessment following robotic mitral valve repair versus conventional sternotomy

Objective: Robotic-assisted mitral repair has demonstrated excellent late outcomes without increased morbidity and mortality in experienced centers.Robust analysis of postoperative quality of life in large cohorts has been limited. Methods:Between January 1, 2020, and April 1, 2024, 563 adult patients who underwent mitral repair for degenerative mitral regurgitation at our institution were retrospectively reviewed.Patient-Reported Outcomes Information System Global Health 10-question survey (PROMIS-10) physical and mental scores, as well as MacNew social scores were evaluated at baseline and serial follow-up at 1 month, 3 months, 6 months, and 1 year.Quality of life (QoL) metrics were evaluated longitudinally using a nonlinear multiphase mixed-effects regression model. Results:A total of 1493 postoperative QoL measurements were available in 563 patients (247 robotic vs 316 sternotomy).Patients who received a robotic approach were younger than those who underwent sternotomy (age 58 10 years vs age 66 10 years; P<.001) with fewer comorbidities and higher baseline PROMIS-10 physical (55 robotic vs 51 sternotomy; P<.001) and mental (57 vs 53; P<.001) scores.There was no significant difference in temporal outcomes between groups (physical: P = .11;mental: P = .84;social: P = .55).Each metric in both groups surpassed the population norm and returned to preoperative baseline within 6 months (graphical abstract). Conclusions:Postoperative QoL following mitral valve repair was excellent, regardless of approach.Patients who were selected for a robotic approach demonstrated higher baseline QoL metrics than those who received a sternotomy, but this did not translate to a comparative improvement on adjusted analyses and QoL for most patients returned to baseline by 6 months.The operative approach for mitral valve repair in patients who are candidates for a minimally invasive procedure should be tailored to surgeon experience in offering a safe, durable repair.