How to implement a clinical robotic mitral valve surgery program

Minimally invasive, specifically, robot-assisted mitral valve surgery has evolved as a method to intervene on mitral valve disease without a median sternotomy while providing the advantages of excellent visualization and allowing for precise technical movements in a small space with the goal to decrease surgical invasiveness, post-operative pain, and hospital length of stay. As patient interest in minimally invasive cardiac procedures become more prevalent and patients seek the opportunity to undergo robotic valve surgery, institutions worldwide are exploring the potential of establishing a robotic mitral valve surgery program. While robust existing experience in open surgical mitral valve repair, careful patient selection, a dedicated team, and institution support are fundamental factors to implement a new robotic mitral valve surgery program, we believe that simulation team training prior to transitioning to live cases is also crucial and should be incorporated to establish a successful mitral valve surgery program.