We went to the Uni clinic in Kiel, Schleswig Holstein, Northern Germany, and the op was done by the head surgeon, Dr. Cremer, who is famous throughout Germany. Didn't realize it before we went but that clinic and their heart surgery department in particular are very well-known there, with heart patients flying in from Berlin and Munich and other major cities which certainly aren't shy on their own good clinics.
"Western lifestyle" is the #1 cause for heart surgery according to Dr. Cremer - soft drinks, alcohol, sugar, fat, smoking, processed foods, no exercise, stress, the works. My wife actually refused to have the test done where they check your arteries coming and going to the heart, a routine but invasive test prior to heart surgery so they know whether you'll need a bypass. Anyone undergoing open heart surgery in that clinic
has to have that test done. We refused because we don't suffer from western lifestyle. According to the nurses and fellow docs there, this was the first time ever this surgeon accepted to do a valve replacement without that test, asking only that if he discovered anything untowards once she was under the knife, we'd give him permission to do a bypass if he deemed it necessary. Which we did and sure enough, he didn't find anything other than the bad valve.
Clean living definitely makes a difference.
Didn't know about the robotic routine but the day we fixed the surgery date, my wife found an Internet link where a US surgeon pioneered a new form of heart surgery that was televised and allowed anyone interested to watch. She read it, I didn't and we didn't have time to watch so I don't know what was new about that procedure but apparently, it was far less invasive than usual and was heralded as a major breakthru in that discipline.
My wife definitely would have died of congestive heart failure without the valve replacement. She knew about her mitral valve condition since she was 20 because she fainted and woke up in a hospital. She had a very good doctor in NY at the time and he told her that surgery then had a 50:50 chance and that she could live a normal life without surgery if she refrained from doing certain things (inverted positions, undue exertion and such). He also advised she become a vegetarian - which she did.
Well, she lived with that bum valve some 35 years but when it finally had deformed so much as to leak badly, there was the backflow into the lungs which made her feel an elephant was sitting on her chest and she couldn't get any wind. We got the surgery date within 10 days of interviewing this surgeon remotely so we were very lucky. At that point, time really was of the essence. We also had a good diagnostician in Cyprus who ran the visual tests and burned them to CD so the German surgeon could look at them and knew exactly what needed to be done.
And yes, my wife didn't want to be on the blood thinner for the rest of her life so she opted for the biological pig skin valve which, they expect, could last up to 20 years. We'll make the most of that time coz she ain't going thru that butchery again

And that phrase isn't meant derogatory - it saved her life. But I saw her in intensive care 30 minutes after she came out of the surgery theater. Lemme tell ya, seeing your loved one (and strangers) still under anesthesia, with bloody pipes coming out of everywhere, the eyes sealed shut, on the breathing machine, with the spirit somewhere else and just a lump of flesh on the table being animated by machines was a very Matrix-type moment. The weirdest thing was to look thru the curtain outside where it was sunny and students were chatting and nibbling on fast food and life was going on normal while inside behind one wall was this dimly lit and quiet 'holding area' for the reanimated zombies.
Bizarre. Certainly reshuffles your priorities.