Surgical and Anesthesia-Related Concerns forRobot-Assisted Pediatric Cardiac Surgery.
| Title: | Surgical and Anesthesia-Related Concerns forRobot-Assisted Pediatric Cardiac Surgery. |
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| Authors: | Kucera JA; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC.; Hughes F; Department of Anesthesiology, Pediatric Cardiac Division, Duke University, Durham, NC.; Wolf SEM; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC.; Greenberg M; Department of Anesthesiology, Pediatric Cardiac Division, Duke University, Durham, NC; Duke Children's Pediatric and Congenital Heart Center, Durham, NC.; Jooste E; Department of Anesthesiology, Pediatric Cardiac Division, Duke University, Durham, NC.; Mensah-Mamfo M; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC.; Reynolds L; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC.; Overbey DM; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC; Duke Children's Pediatric and Congenital Heart Center, Durham, NC.; Turek JW; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC; Duke Children's Pediatric and Congenital Heart Center, Durham, NC.; Einhorn L; Department of Anesthesiology, Pediatric Cardiac Division, Duke University, Durham, NC.; Ames W; Department of Anesthesiology, Pediatric Cardiac Division, Duke University, Durham, NC; Duke Children's Pediatric and Congenital Heart Center, Durham, NC.; Diaz-Rodriguez N; Department of Anesthesiology, Pediatric Cardiac Division, Duke University, Durham, NC; Duke Children's Pediatric and Congenital Heart Center, Durham, NC. Electronic address: natalia.diaz-rodriguez@duke.edu. |
| Source: | Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2026 Feb; Vol. 40 (2), pp. 606-612. Date of Electronic Publication: 2025 Nov 07. |
| Publication Type: | Journal Article; Observational Study |
| Language: | English |
| Journal Info: | Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9110208 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8422 (Electronic) Linking ISSN: 10530770 NLM ISO Abbreviation: J Cardiothorac Vasc Anesth Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : W.B. Saunders, c1991- |
| MeSH Terms: | Cardiac Surgical Procedures*/methods ; Cardiac Surgical Procedures*/adverse effects ; Cardiac Surgical Procedures*/trends ; Robotic Surgical Procedures*/methods ; Robotic Surgical Procedures*/adverse effects ; Robotic Surgical Procedures*/trends ; Anesthesia*/methods ; Anesthesia*/adverse effects ; Heart Septal Defects, Atrial*/surgery; Mitral Valve Insufficiency/surgery ; Humans ; Retrospective Studies ; Male ; Female ; Child ; Adolescent ; Cohort Studies ; Child, Preschool |
| Abstract: | Objective: The purpose of this study is to describe a cohort of pediatric patients undergoing robot-assisted cardiac surgery at a single center and to discuss the anesthetic implications and perioperative considerations to optimize outcomes.; Design: A retrospective observational cohort study.; Setting: Academic tertiary care medical center.; Participants: Nine children underwent robot-assisted cardiac surgery from 2022 to 2024. Indications for operation included atrial septal defect (n = 8) and mitral valve regurgitation with concomitant Marfan syndrome (n = 1).; Interventions: Eight patients underwent atrial septal defect closure; 1 patient underwent mitral valve repair.; Measurements and Main Results: Mean (SD) age was 13.1 (2.5) years, mean (SD) weight was 48.5 (20.3) kg, and mean (SD) body mass index was 21.7 (5.4) kg/m2. Mean (SD) operative time was 388.2 (40.7) minutes, fibrillation time was 92.4 (25.8) minutes, and cardiopulmonary bypass time was 192.1 (31.3) minutes. None of the patients required 1-lung ventilation based on surgeon preference, and most patients (77.8%) were extubated in the operating room. The median (IQR) intensive care unit length of stay was 45 (26) hours, and the median (IQR) hospital stay was 3 (2.5) days. One patient required conversion to median sternotomy due to aortic insufficiency in the setting of Marfan syndrome and aortic root dilation. One patient required a reoperation due to bleeding following an emesis episode in the intensive care unit. There were no mortality events.; Conclusions: Robot-assisted cardiac surgery is well tolerated in appropriately selected pediatric patients, including children as small as 24 kg. Our experience suggests that the success of this approach is predicated upon a center with institutional experience and multidisciplinary collaboration. Furthermore, it is critical that the anesthesiologist understands the unique anatomic, airway, monitoring, positioning, and surgical considerations that are unique for this patient population.; (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors have no conflicts of interest to disclose. |
| Contributed Indexing: | Keywords: pediatric cardiac surgery; robot-assisted cardiac surgery |
| Entry Date(s): | Date Created: 20251206 Date Completed: 20260206 Latest Revision: 20260425 |
| Update Code: | 20260425 |
| DOI: | 10.1053/j.jvca.2025.11.005 |
| PMID: | 41353025 |
| Database: | MEDLINE |
Journal Article; Observational Study