How To Do It: Mitral Valve Translocation

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Medical Device Technology

Background:

• Severe, symptomatic, secondary mitral regurgitation (MR) poses significant clinical challenges.
• Existing treatments may not fully address leaflet tethering and annular dilation.
• Novel approaches are needed to enhance mitral valve function and durability.

Purpose of the Study:

• To describe the novel Mitral Valve Translocation (MVT) procedure.
• To evaluate the efficacy of MVT in improving leaflet coaptation and reducing MR.
• To assess the impact of MVT on patients with severe secondary MR and adverse left ventricular remodeling.

Main Methods:

• MVT involves interposing an autologous pericardial patch between the mitral annulus and native leaflets.
• The procedure detaches the native mitral valve, repositions it deeper into the ventricle, and attaches it to the patch.
• Suturing techniques secure the patch to the annulus and the native valve to the patch.

Main Results:

• MVT increases total leaflet surface area and creates supranormal coaptation.
• The procedure reduces leaflet tethering and mitral annular circumference.
• Short-term follow-up shows sustained MR grades of ≤mild and 14 mm coaptation at 12 months.

Conclusions:

• Mitral Valve Translocation is a promising novel procedure for severe secondary MR.
• MVT effectively enhances leaflet coaptation and may protect against recurrent MR.
• Satisfactory short-term outcomes suggest MVT's potential for improved patient prognosis.