Learning Curve of Robotic Mitral Repair: Prospective Two-Centre Study of Proficiency and Clinical Outcomes

This study investigated the initial experience of two cardiac centers starting their robotic programs evaluating the impact of previous minimally invasive mitral valve surgery (MIMVS) experience on the learning curve. A retrospective analysis was performed on the first consecutive cases using the robotic surgical platform at two European centers, with Center 1 transitioning from conventional surgery and Center 2 transitioning from minithoracotomy MIMVS. The learning process was evaluated using surgical times and a combined primary outcome that included relevant intra- and postoperative results, with the first 62 patients from each center included in the analysis. The turning point at the end of the learning phase was detected at the 60th case in Center 1 and at the 50th in Center 2. Regarding surgical time, the learning curve was steeper in Center 1, with both cardiopulmonary bypass and cross-clamp times overcoming the learning phase after 32 cases, as compared to 16 cases in Center 2.