Robotic Heart Valve Surgery: Starr's Ball to ABB

Robotic heart valve surgery lets a surgeon repair or replace a mitral or aortic valve through a few small cuts between the ribs, working from a console instead of sawing through the breastbone. A hospital near Ann Arbor, Michigan, did its first robotic aortic valve replacement this autumn, and the maker of the da Vinci robot has just won new approval for heart work in Europe. This post follows valve surgery from the first caged ball valves to keyhole repair and then to robots. ABB does not make surgical robots, so it also explains where ABB machines fit and where they do not.

A da Vinci Xi with its arms docked over a patient during the first robotic operation at William Beaumont Army Medical Center, Texas, 2016. Photo: Marcy Sanchez / U.S. Army via Wikimedia Commons (public domain)

How surgeons learned to replace a failing heart valve

The first mechanical valves went in before surgeons could even stop the heart safely. In 1952 Charles Hufnagel implanted a tube and ball valve of his own design in ten patients, six of whom survived the operation. The valve sat in the large artery leaving the heart, not in the heart itself, and it helped by stopping some of the backflow. Hufnagel implants continued for about eight years, but the design never became a reliable standard treatment.

A Hufnagel heart valve, a ball in a clear tube, in the National Museum of Health and Medicine. Photo: Alan Hawk, National Museum of Health and Medicine via Wikimedia Commons (public domain)

The design that lasted came from Portland, Oregon. In 1960 surgeon Albert Starr implanted a caged ball valve developed with engineer Lowell Edwards, and in 1961 the two published their first clinical experience with mitral valve replacement. The Starr-Edwards valve had a silicone ball inside a cage welded to a ring. It stayed in use for 47 years, and one patient's valve worked for 48 years before it was replaced. Each of these operations needed a heart-lung machine and a wide opening of the chest.

A Starr-Edwards caged ball mitral valve. Photo: Dr. Mirko Junge / Wikimedia Commons (CC BY 3.0)

For decades valve surgery meant a sternotomy, splitting the breastbone to reach the heart. In 1996 Delos Cosgrove and colleagues in Cleveland described minimally invasive approaches to both aortic and mitral valve operations through much smaller incisions. Robot assistance arrived within two years: in 1998 Friedrich Mohr's team in Leipzig reported a robot assisted mitral valve operation, and the first cardiac procedures with da Vinci took place in France and Germany that year. In 2000 Randolph Chitwood's team at East Carolina University published a mitral valve repair done with the da Vinci system.

A heart-lung machine beside the team during open heart surgery, 1981. Photo: Jerry Hecht via Wikimedia Commons (public domain)

Robotic heart valve surgery in 2026

Robotic valve programs still open one hospital at a time. In September 2026 MLive reported that surgeons at Trinity Health Ann Arbor Hospital had completed the hospital's first robotic assisted aortic valve replacement. Dr. Robert Lyons led the operation with Dr. Andrew Pruitt and the robotic cardiac team. They worked through several small incisions between the ribs, the largest 3 cm, with no sternotomy. Lyons said the robot offers the same durable valve replacement while reducing the physical impact of surgery. Hospital officials said the patient recovered without complications, and the method now sits alongside transcatheter aortic valve replacement as a less invasive option.

A conventional cardiac operation at Gemelli Hospital in Rome, the open approach that robotic valve surgery avoids. Photo: Pfree2014 / Wikimedia Commons (CC BY-SA 4.0)

Intuitive, the maker of da Vinci, played down heart surgery for years because of the limits of its earlier platforms. On 25 September 2026 MedTech Dive reported that its da Vinci 5 had a CE mark for adult cardiac surgery in Europe. Its CFO had already called cardiac procedures one of the company's most anticipated long term opportunities. The CE mark came after FDA clearance earlier in the year for nine heart procedures, including mitral and tricuspid valve repair and mitral valve replacement. Intuitive said it will add new cardiac instruments and work with a limited number of European centres to build reproducible programs.

A visitor tries the console of a da Vinci Xi, made by Intuitive, at Keesler Medical Center in 2017. Photo: Kemberly Groue / U.S. Air Force via Wikimedia Commons (public domain)

ABB does not make surgical robots, and no ABB robot takes part in these operations. ABB's arms work on the manufacturing side. Tissue heart valves and the delivery systems for catheter valves are made in clean rooms, much of the work by hand, and the small, careful assembly steps there are the kind of job ABB's YuMi was designed for: working beside people on light assembly without safety fences. Our post on medical device manufacturing covers how cobots already work in that industry.

An ABB YuMi works beside an operator on a production line, from ABB's YuMi anniversary material. Photo: ABB

Where robotic heart valve surgery goes next

Over the next years more patients will choose between three routes: open surgery, a catheter valve pushed in through an artery, or a robotic operation through the ribs. Catheter valves avoid surgery altogether, while a surgical repair of a leaking mitral valve can keep the patient's own valve in place. Our cardiac catheter robot post covers the catheter side. The robotic route will grow where hospitals can train whole teams. Pruitt said these procedures are complex and need close coordination among many highly skilled caregivers.

Five generations of mechanical heart valves, from top: Starr-Edwards, Kay-Shiley, Cooley-Cutter, Björk-Shiley and St. Jude Medical. Photo: Kuroczynski / Wikimedia Commons (CC BY-SA 4.0)

In factories, rising valve and instrument volumes mean more precise, repetitive work in clean rooms. A single arm YuMi IRB 14050 or a GoFa CRB 15000 cobot could handle parts, test fixtures or package sterile components next to skilled workers, with the cell planned and checked in RobotStudio first. ABB has not announced a heart valve customer project, so this is a possibility. The fine sewing of tissue valves would be much harder to automate and will likely stay with people for a long time.

A single-arm YuMi IRB 14050 in its cell on GE Healthcare's prototype line in Helsinki. Photo: ABB

Cost comes first among the open problems. A surgical robot costs a lot to buy and to run, and a valve operation through small ports usually takes a team time to learn. Intuitive says it is focused on generating clinical evidence, and centres will need long term data on valve durability and recovery to compare robotic, open and catheter routes. For a patient, Lyons put the gain this way: the same valve replacement without a split breastbone, less pain, and a quicker return to normal activities.

ABB GoFa cobots on mobile bases at the automated laboratory ABB built with XtalPi in China. Photo: ABB

Innovation

AI solutions for effortless ABB robot control.

Automation

Robotics

ceojohntran@chatwithrobot.net

+84905311611

© 2025. All rights reserved.

qtran1215@gmail.com