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Transapical mitral valve repair procedures: primetime for microinvasive mitral valve surgery
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  • Augusto D'Onofrio,
  • Alessandro Fiocco,
  • Matteo Nadali,
  • Gino Gerosa
Augusto D'Onofrio
University of Padova School of Medicine and Surgery
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Alessandro Fiocco
University of Padova School of Medicine and Surgery
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Matteo Nadali
University of Padova School of Medicine and Surgery
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Gino Gerosa
University of Padova School of Medicine and Surgery
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Abstract

Introduction: Nowadays micro-invasive procedures (off-pump, beating heart) for mitral valve repair (MVRe) are abruptly expanding with the potential to be adopted as a valuable alternative to surgery. In the present manuscript, the Authors review the available technologies intended to treat mitral regurgitation (MR) through transapical approach, including annuloplasty and chordal repair options. Annuloplasty: To date, Valcare Amend is the only transapical mitral valve (MV) ring to have been implanted in patients. The device allows for stabilization of the annulus through a complete semirigid D-shaped ring. The first-in-human successful procedure was performed in 2016 by our Group and subsequent clinical experience included a total of 14 implanted patients. Currently the technology is under clinical trial evaluation to validate the efficacy and safety profile of the device. Chordal Repair: Beating heart chordal implantation via trans-apical approach is a current feasible, safe and reproducible option. Neochord DS1000 is the most widely used technology in the field, with a solid procedural experience and good results in well-selected patients. Its clinical use has been validated in Europe since 2012, while it is still under clinical investigation in the United States. Harpoon TDS-5 system is a novel technology, recently CE mark approved for clinical use. Conclusions: Transapical micro-invasive technologies are current viable therapies to treat MR in selected patients. Embracing transcatheter MVRe therapies should guide the cardiac surgeon through the new revolution of micro-invasive MV tailored repair.

Peer review status:IN REVISION

03 May 2021Submitted to Journal of Cardiac Surgery
06 May 2021Assigned to Editor
06 May 2021Submission Checks Completed
06 May 2021Reviewer(s) Assigned
10 May 2021Review(s) Completed, Editorial Evaluation Pending
10 May 2021Editorial Decision: Revise Minor