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Related Experiment Video

Updated: Apr 24, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Experimental transapical endoscopic ventricular visualization and mitral repair.

Tamas Ruttkay1, Markus Czesla1, Henrietta Nagy2

  • 1Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany.

The Thoracic and Cardiovascular Surgeon
|September 11, 2014
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Summary

This study developed a minimally invasive transapical endoscopic technique for complex on-pump mitral valve repair in human cadavers. The method allows direct visualization for precise surgical interventions, offering potential advantages for intricate mitral valve repairs.

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Techniques
  • Surgical Innovation

Background:

  • Growing interest in endoscopic mitral valve repair from animal studies.
  • Need for advanced techniques in human cadavers for complex repairs.
  • Focus on transapical endoscopic approaches during on-pump procedures.

Purpose of the Study:

  • To develop a method for complex transapical endoscopic mitral valve repair in human cadavers.
  • To adapt existing techniques for on-pump cardiac operations.
  • To evaluate the feasibility of minimally invasive complex mitral valve repair.

Main Methods:

  • Preparation of 20 human cadavers with a left anterolateral minithoracotomy.
  • Introduction of a rigid endoscope and instruments via an apical port with CO2 insufflation.
  • Experimental repair involving chordal replacement with a clip chord and segmental leaflet excision with valvuloplasty.

Main Results:

  • Direct visualization of mitral leaflet coaptation and subvalvular apparatus achieved.
  • Successful transapical complex mitral repair performed in all cases using intracardiac imaging.
  • Demonstrated feasibility of advanced endoscopic repair techniques.

Conclusions:

  • The transapical endoscopic method shows promise for on-pump mitral valve repair.
  • This minimally invasive approach is suitable for complex mitral valve repair cases.
  • Potential for improved outcomes in complex cardiac surgeries.