Robotic vs. Sternotomy Mitral Repair: Quality of Life Outcomes Tell a Surprising Story

Robotic-assisted mitral valve repair has gained ground in recent years, with excellent late outcomes in experienced centres. But how patients feel after surgery — physically, mentally, and socially — has rarely been studied at scale. A Cleveland Clinic team set out to change that by following 563 adults who underwent mitral repair for degenerative mitral regurgitation between 2020 and 2024.

Quality of life was assessed at baseline and at 1, 3, 6, and 12 months postoperatively using the PROMIS-10 Global Health survey for physical and mental dimensions — and the MacNew social subscale to capture the social fabric of recovery that PROMIS-10 does not measure as deeply. A nonlinear multiphase mixed-effects regression model was applied to 1,493 longitudinal measurements (247 robotic vs 316 sternotomy patients).

While robotic patients started younger and healthier, the temporal trajectories of both groups were remarkably similar: physical, mental, and MacNew social scores all returned to preoperative baseline within six months, and each metric surpassed population norms. There was no significant difference in temporal outcomes between surgical approaches.

By including the MacNew social domain alongside PROMIS-10, the investigators were able to capture something most cardiac trials miss: how surgery affects relationships, social roles, and participation in daily life. The result is a more complete picture of recovery — and a reminder that what matters to patients is not only how long they live, but how fully.

Reference:
Bakir, N. H., Damara, F. A., Burns, D. J. P., Houghtaling, P. L., DiPaola, L. M., Svensson, L. G., Blackstone, E. H., Malas, T., & Gillinov, M. (2026). Longitudinal quality of life assessment following robotic mitral valve repair versus conventional sternotomy. JTCVS Open, 29, 101503. https://doi.org/10.1016/j.xjon.2025.11.001