[Standardization and Education in Minimally Invasive Mitral Valve Repair]
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Updated: Nov 7, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Ichiro Matsumaru1, Takashi Miura
1Department of Cardiovascular Surgery, Nagasaki University, Nagasaki, Japan.
Abstract:
We performed minimally invasive cardiac surgery for mitral repair (MICS-MP) in 386 of 612 consecutive MICS patients (63.1%) from August 2010 to December 2025 using an exoscope-assisted approach. Hospital mortality was 0.8%.Freedom from reoperation was 96.6% at a median follow-up of 75 months, and 92.3% of patients maintained mild-or-less mitral regurgitation at final echocardiographic follow-up. We present our standardized protocol covering preoperative selection, perfusion thresholds, a 5-step repair algorithm, and a 4-stage step-by-step training program, providing a reproducible framework for safe MICS-MP.
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