OR / Prep · Cardiac Surgery · open
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Mitral valve repair
Why are we operating?
Reconstruction of a leaking mitral valve on bypass, resecting or re-suspending the prolapsing segment and reinforcing the annulus with a ring, repair beats replacement when the valve allows it.
Indication: Severe mitral regurgitation from degenerative prolapse, symptomatic or with early ventricular dilatation, ideally repaired before the ventricle pays for the leak.
The operation in 4 steps
01Bypass and exposure
02Valve analysis
03Reconstruction
04Testing and weaning
Danger zones
Left main coronary artery
Two territories hang from one vessel; its disease changes the whole operative plan.
AV nodal artery
Injury or occlusion at the crux trades a rhythm for an infarct.
Coronary sinus
Thin-walled and posterior, easily torn by retraction during mitral exposure.
Watch it done
Demystifying mitral valve repair
Why repair beats replacement for degenerative disease, and what the surgeon does to the leaflet.
Source: Cleveland Clinic · Watch on YouTubeCreating the chordae system for anterior leaflet mitral repair
Operative footage of artificial chordae for the anterior leaflet.
Source: CTSNet · Watch on YouTube
Conceptual teaching for learners preparing to observe and assist under supervision, not operative instructions. Five minutes from now you should know why this operation exists, what its shape is, and which structures it is designed not to injure.