What's New in Mitral Valve Repair?

Mitral valve repair is the standard of care for degenerative mitral valve pathology, as established by the median sternotomy approach. Equivalently excellent results can be achieved by a variety of more minimally invasive approaches depending on institutional experience and preferences. At the Minneapolis Heart Institute®, we have experience with and utilize all approaches to mitral valve repair for degenerative disease including full and hemisternotomy, right thoracotomy, mini-thoracotomy and heart port approaches. We believe that logistic, economic, and anticipated benefit constraints currently limit the application and the robotic technology. Leaflet maneuvers continue to be important in mitral valve repair, but recently we have revisited the concept of simplifying a “complex” repair in the setting of a subset of severe degenerative (Barlow's) disease by utilizing only an oversized mitral valve ring with excellent results. As suggested by others, in the appropriate setting of bileaflet prolaps...