Skip to main content
Log in

Minimally invasive surgery of mitral valve (MIS-MV)

  • Current Topics Review Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Following the revision of the therapeutic guideline of ACC/AHA in (Circulation 114:450–527, 2006), the incidence of mitral valve repair in asymptomatic patients with moderate or severe mitral valve regurgitation has increased. For mitral valve repair, the quality and outcomes as well as lower invasive procedure are important to obtain the confidence of cardiologists and ensure request of early phase operation from cardiologists. With recent innovations of technologies and the development of revolutionary techniques, minimally invasive surgery of the mitral valve (MIS-MV) has become a widespread surgical option of mitral valve repair. It is vital, however, that careful preoperative assessment, and planning of the approach and perfusion strategy are put in place to perform MIS-MV safely.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Bonow RO, Carabello BA, Chattenrjee K, de Leon AC, Faxon DP, Freed MD. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease : executive summary. A report of the American College of Cardiology/American Heart Association Task Force Guideline. Circulation. 2006;114:450–527.

    Article  Google Scholar 

  2. Navia JL, Cosgrove DM. Minimally invasive mitral valve operation. Ann Thorac Surg. 1996;62:1542–4.

    Article  CAS  PubMed  Google Scholar 

  3. Mihaljevic T, Chon LH, Unic D, Aranki SF, Couper SC, Byrne JG. One thousand minimally invasive valve operations. Early and late results. Ann Surg. 2004;240:529–34.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Cosgrove DM III, Sabik JF. Minimally invasive approach for aortic valve operation. Ann Thorac Surg. 1996;62:596–7.

    Article  PubMed  Google Scholar 

  5. Cohn LH, Adams DH, Couper GS, Bichell DP, Rosborough DM, Samuel P, et al. Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair. Ann Surg. 1997;226:421–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Bonacchi M, Prifti E, Giunti G, Frati G, Suri RM. Does ministernotomy improve postoperative outcome in aortic valve operation? A prospective randomized study. Ann Thorac Surg. 2002;73:460–6.

    Article  PubMed  Google Scholar 

  7. Shekar PS, Cohn LH. Minimally invasive cardiac surgery. In: Cohn LH, editor. Cardiac surgery in the adult. 3rd ed. New York: McGraw-Hill; 2008. p. 957–64.

    Google Scholar 

  8. Gillinov AM, Banbury MK, Cosgrove DM. Hemisternotomy approach for aortic and mitral valve surgery. J Card Surg. 2000;15:15–20.

    Article  CAS  PubMed  Google Scholar 

  9. Gundry SR, Shattuck OH, Razzouk AJ, del Rio MJ, Sardari FF, Bailey LL. Facile minimally invasive cardiac surgery via ministernotomy. Ann Thorac Surg. 1998;65:1100–4.

    Article  CAS  PubMed  Google Scholar 

  10. Doty DB, DiRusso GB, Doty JR. Full-spectrum cardiac surgery through a minimal incision: mini-sternotomy (lower half) technique. Ann Thorac Surg. 1998;65:573–7.

    Article  CAS  PubMed  Google Scholar 

  11. Karagoz HY, Bayazit K, Battaloglu B, Kurtoglu M, Ozerdem G, Baakkaloglu B, Sonmez B. Minimally invasive mitral valve surgery: the subxiphoid approach. Ann Thorac Surg. 1999;67:1328–33.

    Article  CAS  PubMed  Google Scholar 

  12. Pompili MF, Stevens JH, Burdon TA, et al. Port-access mitral valve replacement in dogs. J Thorac Cardiovasc Surg. 1996;112:1268–74

    Article  CAS  PubMed  Google Scholar 

  13. Guliemos V, Wunderlich J, Dangel M, et al. Minimally invasive mitral valve surgery—clinical experiences with a PortAccess system. Euro J Cardiothorac Surg. 1998;14(Suppl 1):S148–53.

    Article  Google Scholar 

  14. Glower DD, Landolfo KP, Clements F, et al. Mitral valve operation via Port Access versus median sternotomy. Euro J Cardiothorac Surg. 1998;14(Suppl 1):S143–7.

    Article  Google Scholar 

  15. Sharony R, Grossi EA, Saunder PC, et al. Minimally invasive aortic valve surgery in the elderly: a case-control study. Circulation 2003;108(Suppl 1):II43–7.

    Google Scholar 

  16. Minale C, Reifschneider HJ, Schmitz E, et al. Minimally invasive aortic valve replacement without sternotomy. Experience with the first 50 cases. Euro J Cardiothorac Surg. 1998;14(Suppl 1):S126–9.

    Article  Google Scholar 

  17. McClure RS, Athanasoulos LV, McGurk S, Davidson MJ, Couper GS, Cohn LH. One thousand minimally invasive mitral valve operations: early outcomes, late outcomes, and echocardiographic follow-up. J Thorac Cardiovasc Surg. 2013;145:1199–206.

    Article  PubMed  Google Scholar 

  18. Cohn LH. Minimally invasive aortic valve surgery: technical consideration and results with the parasternal approach. J Card Surg. 1998;13:302–5.

    Article  CAS  PubMed  Google Scholar 

  19. Greelish JP, Cohn LH, Leacche M, Kravas A, Fox J, Byrne JB, Aranki SF, Couper GS. Minimally invasive mitral valve repair suggests earlier operation for mitral valve disease. J Thorac Cardiovasc Surg. 2003;126:365–71.

    Article  PubMed  Google Scholar 

  20. Navia JL, Cosgrove DM. Minimally invasive valve operation. Ann Thorac Surg. 1996;62:1542–4.

    Article  CAS  PubMed  Google Scholar 

  21. Mohr FW, Falk V, Diegeler A, et al. Minimally invasive port-access mitral valve surgery. J Thorac Cardiovasc Surg. 1998;115:567–76.

    Article  CAS  PubMed  Google Scholar 

  22. Grossi EA, LaPietra A, Ribakove G, et al. Minimally invasive versus sternotomy approaches for mitral reconstruction : comparison of intermediate-term results. J Thorac Cardiovasc Surg. 2001;121:708–13.

    Article  CAS  PubMed  Google Scholar 

  23. Casselman FP, Van Slycke S, Wellens F, De Geest R, Degrieck I, Van Praet F, Vanermen H. Mitral valve surgery can now routinely be performed endoscopically. Circulation 2003;108(suppl 1):II48–54.

    Google Scholar 

  24. Suri RM, Schaff HV, Meyer SR, Hargrove WC 3rd. Thoracoscopic versus open mitral valve repair: a propensity score analysis of early outcomes. Ann Thorac Surg. 2009;88:1185–90.

    Article  PubMed  Google Scholar 

  25. Chitwood WR, Elbeery JR, Moran JF, the Minimally Invasive Surgery Workgroup. Minimally invasive mitral valve repair using transthoracic aortic occlusion. Ann Thorac Surg. 1997;63:1477–9.

    Article  PubMed  Google Scholar 

  26. Yozu R, Shin H, Maehara T. Minimally invasive cardiac surgery by the port-access method. Artif Organs. 2002;26:430–7.

    Article  PubMed  Google Scholar 

  27. Maselli D, Pizio R, Borellia G, Musumeci F. Endovascular balloon versus transthoracic aortic clamping for minimally invasive mitral valve surgery: impact on cerebral microemboli. Interact CardioVasc Thorac Surg. 2006;5(2):183–6.

    Article  PubMed  Google Scholar 

  28. Petracek MR, Leaacche M, Solenkova N, Umakanthan R, Ahmad RM, Ball SK, et al. Minimally invasive mitral valve surgery: expands the surgical option for high-risk patients. Ann Thorac Surg. 1999;67(1328–33):18.

    Google Scholar 

  29. Galloway AC, Schwarts CF, Ribakove GH, Crooke GA, Gogoladze G, Ursomanno P, Mirabella M, Culliford AT, Grossi EA. A decade of minimally invasive mitral repair: long-term outcomes. Ann Thorac Surg. 2009;88:1180–4.

    Article  PubMed  Google Scholar 

  30. Cheng DC, Martin J, Diegele A, Folliguet TA, Nifong LW, Perier P, Raanani E, Smith JM, Seeburger J, Falk V. Minimally invasive versus conventional open mitral valve surgery: a meta-analysis and systemic review. Innovations (Phila). 2011;6(2):84–103.

    Article  Google Scholar 

  31. Seeburger J, Borger MA, Doll N, Walter T, Passage J, Falk V, et al. Comparison of outcomes of minimally invasive mitral valve surgery for posterior, anterior, and bileaflet prolapse. Eur J Cardiothorac Surg. 2009;36:532–8.

    Article  PubMed  Google Scholar 

  32. Speziale G, Nasso G, Esposito G, Conte M, Greco E, Fattouch K, et al. Result of mitral valve repair for Barlow disease (bileaflet prolapse) via right minithoracotomy versus conventional median sternotomy: a randomized trial. J Thorac Cardiovasc Surg. 2011;142:77–83.

    Article  PubMed  Google Scholar 

  33. Raanani E, Spiegelstein D, Sternik L, Preisman S, Moshkovitz Y, Smolinsky AK, et al. Median sternotomy versus port-access approach. J Thorac Cardiovasc Surg. 2010;140:86–90.

    Article  PubMed  Google Scholar 

  34. Suri RM, Burkhart HM, Daly RC, Dearani JA, Park SJ, Sundt TM III, et al. Robotic mitral valve repair for all prolapse subsets using techniques identical to open valvuloplasty: establishing the benchmark against which percutaneous interventions should be judged. J Thorac Cardiovasc Surg. 2011;142:970–9.

    Article  PubMed  Google Scholar 

  35. Kypson AP, Nifong LW, Chitwood WR Jr. Robot-assisted surgery: training and re-training surgeons. Int J Med Robot. 2004;1(70–6):19.

    Google Scholar 

  36. Chitwood WR Jr, Rodriguez E, Chu MWA, Hassan A, Ferguson TB, Vos PW, Nifong LW. Robotic mitral valve repair in 300 patients: a single center experience. J Thorac Cardiovasc Surg. 2008;136:436–41.

    Article  PubMed  Google Scholar 

  37. Mihaljevic T, Jarret CM, Gillinov AM, William SJ, DeVlliers PA, Stewart WJ, et al. Robotic repair of posterior mitral valve prolapse versus conventional approaches: potential realized. J Thorac Cardiovasc Surg. 2011;141:72–80.

    Article  PubMed  Google Scholar 

  38. McGoon DC. Repair of mitral insufficiency due to ruptured chordae tendineae. J Thorac Cardiovasc Surg. 1960;39(3):357–62.

    Google Scholar 

  39. Carpentier A. Cardia valve surgery—the “French correction”. J Thorac Cardiovasc Surg. 1983;86(3):323–37.

    CAS  PubMed  Google Scholar 

  40. David TE, Bos J, Rakowski H. Mitral valve repair by replacement of chordae tendineae with polytetrafluoroethylene suture. J Thorac Cardiovasc Surg. 1991;101:495–501.

    CAS  PubMed  Google Scholar 

  41. Kawazoe K, Eishi K, Kobayashi Y, et al. Clinical experience of mitral valve reconstruction with artificial chordae implantation. Eur J Cardiothorac Surg. 1992;6:297–301.

    Article  CAS  PubMed  Google Scholar 

  42. Kasegawa H, Komata S, Hirata S, et al. Simple method for determining proper length of artificial chordae in mitral valve repair. Ann Thorac Surg. 1994;57:237–9.

    Article  CAS  PubMed  Google Scholar 

  43. Oppell UOV, Mohr FW. Chordal replacement for both minimally invasive and conventional mitral valve surgery using premeasured gore-tex loops. Ann Thorac Surg. 2000;70:2166–8.

    Article  Google Scholar 

  44. Kudo M, Yozu R, Kokaji K, Iwanaga S. Feasibility of mitral valve repair using the loop technique. Ann Thorac Cardiovasc Surg. 2007;13:21–6.

    PubMed  Google Scholar 

  45. Okamoto K, Kudo M, Yozu R. Loop-in-loop technique on mitral valve repair via mini-thoracotomy. Ann Thorac Surg. 2012;93:1329–30.

    Article  PubMed  Google Scholar 

  46. Woo YJ, MacArthur Jr. Posterior ventricular anchoring neochordal repair of degenerative mitral regurgitation efficiently remodels and repositions leaflet prolapse. Eur J Cardiothorac Surg 2013. doi:10.1093/ejcts/ezt092.

  47. MacArthur JW Jr, Cohen JE, Goldstone AB, Fairman AS, Edwards BB, Hornick MA, Atluri P, Woo YJ. Nonresectional single-suture remodeling for degenerative mitral regurgitation Facilitates Minimally Invasive Mitral Valve Repair. Ann Thorac Surg. 2013;96(5):1603–6.

    Article  PubMed  Google Scholar 

  48. Yozu R, Okamoto K, Kudo M, Nonaka H, Adams DH. New innovative instruments facilitate both direct-vision and endoscopic-assist mini-mitral valve surgery. J Thorac Cardiovasc Surg. 2012;143:S82–5.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The author declares that he has no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mikihiko Kudo.

Additional information

This review was submitted at the invitation of the editorial committee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kudo, M., Yozu, R. Minimally invasive surgery of mitral valve (MIS-MV). Gen Thorac Cardiovasc Surg 62, 342–350 (2014). https://doi.org/10.1007/s11748-014-0398-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-014-0398-6

Keywords

Navigation