Minimally-Invasive Mitral Valve Repair Techniques

1.) Frequently, posterior leaflet prolapse results from a ruptured chord that normally prevents the leaflet from prolapsing.

2.) In this repair, the prolapsing segment of the leaflet is removed along with its ruptured chord.

3.) The diameter of the mitral valve is slightly reduced to accommodate the resected portion. The cut edges of the leaflet are sewn together.

4.) A fabric ring is placed around the repair to reinforce it and enhance its durability.

The leading edges of the prolapsing leaflets are identified.

The leading edges are lined up. Sewing them together at their midpoint prevents the leaflets from prolapsing.

The center portion or “scallops” of the two leaflets are sewn together. Blood can still flow through the valve in either side of this “double-barrel arrangement.”

In cases where the mitral valve leaks between the leaflets because the diameter or annulus of the valve is too dilated, simply placing a constricting annuloplasty band can often bring the leaflets into correct position.