Washington University and Barnes-Jewish Heart & Vascular Center continues to be a leader in perfecting treatments for heart valve conditions. In October 2024, Tsuyoshi Kaneko, MD, WashU Medicine division director of cardiothoracic surgery at Barnes-Jewish Hospital, performed the hospital’s first robotic-assisted mitral valve surgery. Barnes-Jewish is the only hospital within 200 miles of St. Louis offering this innovative, robotic mitral valve repair.

Dr. Kaneko has leveraged the benefits of robotic-assisted surgery for repairing leaky or narrowed mitral valves using the robotic assistance to provide truly minimally invasive surgery. During the procedure, Dr. Kaneko uses robotic tools to fix regurgitation or leaking valves by placing an annuoplasty ring, removing excess tissue, or fixing valve leaflets. It’s less invasive compared with open-heart surgery, so patients experience:

• Less pain during recovery
• Lower risk of infection
• Reduced blood loss
• Shorter hospital stays
• Quicker return to activities

“We see these patients experience significantly lower pain postoperatively as compared to open-heart surgery due to the smaller incisions. Some of our patients are even able to go home on postoperative day three,” said Dr. Kaneko.

Less risk for patients

Robotic-assisted surgery has fewer risks for patients as compared to open-heart surgery. Smaller incisions reduce the amount of blood loss during surgery and lessen the risk of infection post-surgery. Robotic-assisted surgery also minimizes scarring, leaving a few smaller scars compared to the 10-inch scar on the chest left from traditional surgery.

“Patients often experience faster recovery time, minimal scarring, and generally are up and walking within a day,” said Kaneko.

Improved precision

For surgeons, robotic technology provides additional flexibility, dexterity, articulation, visualization, and stability. “Use of the robot provides full articulation of the arm allowing me to perform more precise movements that enhances the accuracy of the surgery,” said Dr. Kaneko.

During robotic-assisted surgery, Dr. Kaneko uses 3D visualization provided by a camera mounted at the head of the robotic instrument along with joystick-controlled tools that work as extensions of his own hands. 

“Our instruments articulate like a human wrist. It’s like having four arms inside the patient’s chest with super-fine capabilities,” Kaneko says. “We are able to operate through tiny ports between the ribs.”

A year in the making

Training and preparation to perform the first mitral valve robotic surgery at Barnes-Jewish was a 12-month process beginning with a grant awarded by the Thoracic Surgery Foundation.

“Our team prepared for more than a year before completing our first surgery, including performing on cadaver models, multiple practice runs, and simulated surgeries,” said Dr. Kaneko.

Multidisciplinary expertise at Washington University and Barnes-Jewish Heart & Vascular Center

WashU Medicine specialists at Barnes-Jewish Hospital are pioneers in transcatheter mitral valve interventions, accumulating substantial expertise that extends to robotic-assisted procedures. Our center was also one of the first in the nation to perform transcatheter aortic valve replacement (TAVR) and only the third in the world to perform a transcatheter tricuspid valve replacement (TTVR). The center is one of six Mitral Valve Repair Reference Centers in the Midwest as designated by the Mitral Foundation and the American Heart Association®.

Because The Heart & Vascular Center has a full suite of treatment options, providers—including WashU Medicine cardiologists, interventional cardiologists, and cardiac surgeons—evaluate patients based on their unique characteristics and make a recommendation based on clinical presentation and disease severity. This allows the team to treat a wide variety of patients, even in those with complex conditions.

Refer a patient

Robotic-assisted surgery may be appropriate for patients with:

• Mitral valve regurgitation
• Mitral valve stenosis
• Mitral valve prolapse
• Ischemic mitral regurgitation
• Degenerative mitral valve disease
• Functional mitral regurgitation

Patients with some conditions may not be suitable for this surgery, including those with morbid obesity, severe COPD, or poor heart function.  However, the majority of patients are candidates for robotic cardiac surgery.

To refer a patient for evaluation at the Heart and Vascular Center, call 314-286-1194. Your patient will benefit from:

• Highly skilled physicians and heart team: Our team has decades of experience, and our program has early access to new treatments. We are a high-volume center with experience performing a range of valve repair and replacement procedures. Both cardiologists and cardiac surgeons participate in assessments, so you can have confidence the team will recommend the most appropriate treatment. 
• Experience and advanced techniques: Our WashU Medicine and Barnes-Jewish team provides care backed by extensive experience in perfecting new methods to correct valve conditions.
• Modern, well-equipped facilities: Our physicians have access to the latest technology, with the capability to perform procedures with enhanced precision. Our high-tech operating rooms are equipped with integrated systems that enable physicians to see imaging in real time. 

To refer your patient to our Heart & Vascular Center, call 314-286-1194 or fill out a referral form.