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Updated: Jul 16, 2026
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Feasibility of mitral valve repair using the loop technique
Mikihiko Kudo1, Ryohei Yozu, Kiyokazu Kokaji
1Department of Surgery, Keio University, School of Medicine, Tokyo, Japan.
Summary
The loop technique simplifies mitral valve repair by improving artificial chordae length determination and ligation, leading to better leaflet movement and reduced pressure gradients compared to traditional methods.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Minimally Invasive Cardiac Surgery
Background:
- Chordal replacement in mitral valve repair using expanded polytetrafluoroethylene (ePTFE) sutures presents challenges in determining artificial chordae length and secure ligation.
- Knot sliding during ePTFE suture ligation is a significant technical difficulty in mitral valve repair.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of a novel loop technique for chordal replacement in mitral valve repair.
- To simplify the process of artificial chordae length determination and ligation during mitral valve repair.
Main Methods:
- The study adopted a loop technique in 12 consecutive mitral valve repair cases.
- Cases included posterior leaflet prolapse, anterior and posterior leaflet prolapse, and anterior leaflet vegetation.
- Chordal replacement was performed using 4 loops in 11 cases and 8 loops in 1 case.
Main Results:
- Postoperative echocardiography demonstrated more physiological posterior leaflet movement with the loop technique compared to resection suture methods.
- The loop technique group showed a significantly lower peak pressure gradient across the mitral valve (1.8+/-0.7 mmHg) versus the non-loop technique group (3.2+/-1.0 mmHg).
- The loop technique appeared hemodynamically superior.
Conclusions:
- The loop technique offers a simplified approach to chordal replacement in mitral valve repair.
- This method is potentially applicable to both minimally invasive cardiac surgery (MICS) and conventional open approaches.
- The study reports the feasibility of the loop technique based on clinical experience.
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