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Review
. 2022 Oct 11;11(20):5993.
doi: 10.3390/jcm11205993.

Decision Making during the Learning Curve of Minimally Invasive Mitral Valve Surgery: A Focused Review for the Starting Minimally Invasive Surgeon

Kinsing Ko  1 , Ad F T M Verhagen  1 , Thom L de Kroon  2 , Wim J Morshuis  1 , Leen A F M van Garsse  1
Affiliations
Review

Decision Making during the Learning Curve of Minimally Invasive Mitral Valve Surgery: A Focused Review for the Starting Minimally Invasive Surgeon

Kinsing Ko et al. J Clin Med. .

Abstract

Minimally invasive mitral valve surgery is evolving rapidly since the early 1990's and is now increasingly adopted as the standard approach for mitral valve surgery. It has a long and challenging learning curve and there are many considerations regarding technique, planning and patient selection when starting a minimally invasive program. In the current review, we provide an overview of all considerations and the decision-making process during the learning curve.

Keywords: decision making; learning curve; minimally invasive mitral valve surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scar of minimally invasive access for mitral valve surgery.
Figure 2
Figure 2
View on the mitral valve in MIMVS. (A) Prolapse of P2 segment. (B) Placement of neochords on the prolapsing segment. (C) Adjusting of the height of the neochords. (D) Result of mitral valve repair.
Figure 3
Figure 3
Setup of a MIMVS procedure by right anterolateral mini thoracotomy. Starting from the bottom of the soft tissue retractor in clockwise direction: Carbon dioxide insufflator, Transthoracic Chitwood clamp, video port and left atrial retractor.
Figure 4
Figure 4
Peripheral arterial and venous cannulation in the right groin. Standard arterial cannula for direct aortic cross clamp technique. When using an endoaortic balloon, there is a sidearm in the arterial cannula to insert the balloon.
Figure 5
Figure 5
Marking of the incisions for MIMVS and the incision for conversion to sternotomy.
See this image and copyright information in PMC

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