Robotic Heart Surgery and Patient Expectations: Advances, Limitations, and the Future of Cardiac Surgery

Leading heart surgeon and educator Dr. Marc Pelletier, MD, in conversation with Dr. Anton Titov, MD, discusses the promises and limitations of modern cardiac surgery technology — including robotic heart surgery, TAVR/TAVI, and emerging mitral valve interventions. While these innovations offer less invasive options and quicker recovery, not all patients are good candidates. Dr. Pelletier emphasizes the importance of realistic expectations, careful patient selection, and the role of the physician in guiding patients through complex decisions during stressful times in their lives.

Jump To Section

• Technology in Cardiac Surgery and Managing Expectations
• Robotic Heart Surgery: Benefits and Limitations
• TAVR/TAVI and the Future of Aortic Valve Replacement
• Innovations in Mitral Valve Treatment
• Future Trends in Cardiac Surgery
• Full Transcript

Technology in Cardiac Surgery and Managing Expectations

Dr. Marc Pelletier, MD reflects on a comment made earlier in the discussion by Dr. Anton Titov, MD about technology in medicine. In today’s technology-driven world, advances in cardiac surgery are remarkable — but they can also lead to patient misconceptions. Some patients believe that if a new technology exists, they automatically qualify for it. One of the challenges for surgeons is to assess patients correctly and set realistic expectations. The physician’s role is to guide the patient through a difficult and stressful time, determining when technology can and should be used.

Robotic Heart Surgery: Benefits and Limitations

One frequent question patients ask is: “Can you do my surgery robotically?” While robotic heart surgery can be the right choice for certain individuals, the majority of patients are not good candidates. According to Dr. Pelletier, there are specific medical reasons why some patients cannot safely or effectively undergo robotic surgery. Technology may play a major or minor role in each case, and surgeons must balance innovation with patient safety and surgical success.

TAVR/TAVI and the Future of Aortic Valve Replacement

New heart treatment technologies are transforming cardiac care. One of the most notable examples is TAVR/TAVI (Transcatheter Aortic Valve Replacement/Implantation), a procedure that did not exist 15 years ago. Today, in the United States, more than half of all aortic valve replacements are performed using TAVI. This shift has dramatically changed the way surgeons approach aortic valve disease, offering less invasive options to patients who once had no surgical alternative.

Innovations in Mitral Valve Treatment

The next major breakthrough may be in treating mitral valve disease, including mitral valve insufficiency and mitral valve stenosis — conditions that are even more common than aortic valve problems. Dr. Pelletier notes that 20 to 30 companies are currently investing billions of dollars to develop new mitral valves and devices designed to repair or replace them using less invasive approaches. These innovations could soon revolutionize how surgeons treat mitral valve conditions, just as TAVI transformed aortic valve surgery.

Future Trends in Cardiac Surgery

The trajectory of cardiac surgery is clear: less invasive operations, reduced pain, faster recovery, and equal safety compared to open-heart surgery. Dr. Pelletier is confident that upcoming technologies will meet these goals, benefiting patients by improving comfort and reducing recovery time without compromising durability or long-term outcomes. He describes this as an “exciting time to be part of cardiac surgery” and expresses his enthusiasm for continuing to participate in the technological revolution that is reshaping the specialty.

Full Transcript

Dr. Anton Titov, MD: Can you do my surgery robotically? How do we manage patients’ expectations? New treatments bring new expectations. Robotic heart surgery, stem cell therapies, and minimally invasive operations are not always best for everyone. Leading heart surgeon and educator explains. Dr. Marc Pelletier, is there anything else you’d like to add to our conversation? You are at the forefront of cardiac surgery. You are training cardiac surgery residents. You are a very motivated and highly driven person and professional.

Dr. Marc Pelletier, MD: Maybe one of the things is this. You made a very astute comment when we started talking about technology. It’s something I’ve been thinking about since you said it. You are absolutely correct that we are a technology-driven world now. The advances of technology are great. What we’re able to do in heart surgery is remarkable. Sometimes patients think that because the technology is there, automatically they’re going to be a candidate for that technology. The challenge for us is sometimes trying to assess those patients correctly.

Dr. Anton Titov, MD: We have to establish some realistic expectations in patients. One example would be this. Patients come in and they say, “Can you do my surgery robotically?”

Dr. Marc Pelletier, MD: Sometimes the answer is “Yes.” But the majority of the time the answer is “No, and you’re not a good candidate for robotic surgery — because of these reasons and those reasons.” The interface of technology and a physician is so important. Our job as physicians is to help guide a patient through a really stressful time in their lives. Sometimes technology will play a role in that. Sometimes technology will play a lesser role. We have to acknowledge that not all patients are good candidates for a robotic heart surgery.

Dr. Anton Titov, MD: But the technology in cardiac surgery is absolutely remarkable.

Dr. Marc Pelletier, MD: New heart treatment technology is coming from some companies. This cardiac surgery technology helps us as physicians to do what we are trying to do. We talked about TAVR/TAVI. It did not exist at all 15 years ago. Now in the United States, over half of all aortic valve replacements are going to be done with TAVI. That is remarkable. It is possible that the same technology breakthrough is going to happen with the mitral valve treatment. Mitral valve insufficiency or mitral valve stenosis is even a bigger problem than the aortic valve. There are 20 to 30 companies now investing billions of dollars into coming up with new mitral valves. They work on new devices to change the mitral valve.

Dr. Anton Titov, MD: Where we are going in surgery is very clear. There will be less invasive surgery. There will be less pain for patients. There will be more comfort for the patient.

Dr. Marc Pelletier, MD: There will be a quicker recovery after cardiac surgery. The technology will allow us to do all that. It will be equally as safe, as effective, and as durable as open-heart surgery. That will be a really big benefit to our patients with heart problems. I am thrilled to be part of the technological revolution in cardiac surgery. It is an exciting time to be part of cardiac surgery.

Dr. Anton Titov, MD: Hopefully we will see more advances like that in the future. Dr. Pelletier, thank you very much for this conversation! It will be very interesting to patients around the world. We hope to come back to you with more questions in the future.

Dr. Marc Pelletier, MD: Thank you, Anton. Thank you very much!