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Related Concept Videos

Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
166
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

88
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

125
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
125
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

163
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
163
Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

Mitral Regurgitation II: Clinical Features and Diagnostic Tests

143
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
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Related Experiment Video

Updated: Nov 21, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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A conservative screening algorithm to determine candidacy for robotic mitral valve surgery.

Raphaelle A Chemtob1, Per Wierup1, Stephanie L Mick1

  • 1Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.

The Journal of Thoracic and Cardiovascular Surgery
|January 13, 2021
PubMed
Summary

A conservative screening algorithm successfully identified patients with degenerative mitral valve disease for robotic surgery, showing comparable outcomes to traditional sternotomy with reduced complications like atrial fibrillation and shorter hospital stays.

Keywords:
minimally invasivemitral valve repairmitral valve replacementrobotic surgeryscreening algorithm

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Techniques
  • Medical Device Technology

Background:

  • Patient selection for robotically assisted mitral valve repair is complex and debated.
  • Degenerative mitral valve disease is a common indication for surgical intervention.

Purpose of the Study:

  • To assess the outcomes of a conservative screening algorithm for selecting patients with degenerative mitral valve disease for robotic mitral valve repair.
  • To compare the results of robotic surgery with traditional sternotomy in selected patients.

Main Methods:

  • A screening algorithm involving transthoracic echocardiography and computed tomography was applied to 1000 consecutive patients.
  • Patients were selected for either robotic surgery or sternotomy based on the algorithm's criteria.
  • Outcomes including new-onset atrial fibrillation, red blood cell transfusions, hospital stay, and stroke were compared between groups.

Main Results:

  • The screening algorithm selected 605 patients for robotic surgery.
  • Robotic surgery patients experienced less new-onset atrial fibrillation (25% vs. 34%), fewer red blood cell transfusions (10% vs. 17%), and shorter hospital stays (5.2 vs. 5.9 days) compared to sternotomy.
  • Postoperative stroke rates were similar between robotic (0.50%) and sternotomy (1.0%) groups, with no hospital deaths.

Conclusions:

  • A conservative screening algorithm effectively identified 60% of patients with degenerative mitral valve disease suitable for robotic surgery.
  • The outcomes for patients selected via this algorithm were comparable to those undergoing sternotomy.
  • This validated approach aids in selecting appropriate candidates for robotic mitral valve surgery.