Transoesophageal echo-guided mitral valve repair using the Harpoon system

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Medical Devices

Background:

• Severe mitral regurgitation (MR) often results from posterior leaflet prolapse.
• Current treatment options may involve invasive procedures.
• There is a need for minimally invasive repair techniques for MR.

Purpose of the Study:

• To describe a novel transapical off-pump echo-guided mitral valve repair technique.
• To detail the use of the Harpoon device for implanting artificial ePTFE chordae.
• To evaluate the feasibility of this approach for MR due to posterior leaflet prolapse.

Main Methods:

• The Harpoon device is inserted into the left ventricle under echocardiography guidance.
• The device is steered to the prolapsed posterior mitral leaflet.
• A needle perforates the leaflet, releasing an ePTFE chord secured by a double-helix knot on the atrial side.

Main Results:

• The ePTFE chord is tensioned and fixed to the epicardial surface of the ventricle.
• The procedure is performed off-pump with echocardiographic monitoring.
• This technique aims to restore proper leaflet coaptation and reduce MR.

Conclusions:

• Transapical off-pump echo-guided mitral valve repair with the Harpoon device is a proposed method for MR.
• Implantation of artificial ePTFE chordae offers a potential solution for posterior leaflet prolapse.
• Further clinical evaluation is warranted to establish the efficacy and safety of this novel repair technique.