Minimally Invasive Mitral & Tricuspid Valve Surgery Course
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Welcome to the Minimally Invasive Valve Course
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Partners in Minimally Invasive Mitral Valve Surgery
INTRODUCTION TO MINIMALLY INVASIVE MITRAL VALVE SURGERY
Operating Room Setup
Anesthesia Requirements
Perfusion Considerations
Contraindications to Limited Right Thoracotomy Mitral Valve Surgery
Patient positioning
Surgical Instruments & Supplies
Cannulation Technique
Femoral Cannulation and Decannulation
Right axillary artery dissection and cannulation
Right Axillary Decannulation
Intraoperative Tranesophageal Echocardiogram for Venous Cannulation
Transeosphageal Echocardiogram for Arterial Cannulation
Cannulation Technique full video
Axillary Cannulation with 8mm Hemashield Graft
Incision location
Chest marking
Two teams operating
Liposomal Bupivacaine field block and intercostal block.
Positioning of 5mm Trochar for the Endoscope
5mm Scope position and tricuspid view
Cardiac Exposure
Cardiac Exposure Video
Anterior chest wall atrial lift insertion
Anterior chest wall Trocar insertion and its use
Cardiac dissection
Dissection of the aorta from the right pulmonary artery and opening of the oblique sinus
Antegrade Cardioplegia
Antegrade cardioplegia and root vent cannula insertion
Antegrade cardioplegia cannula insertion and crossclamp
Endoscopic Mitral Valve Setup: From incision to crossclamp
Endoscopic Cardiac surgery from pericardials to arrest
Endoscopic from pericardial sutures to arrest
Minimally Invasive Caval Control
Mitral Exposure
Mitral Valve exposure
Annular Suture Placement
Papillary Muscle Exposure
Managing the prosthesis outside of chest
Posterior valve pathology - P2 flail/prolapse Non-Resectional Techniques
P2 Repair with Adjustable multiple chord repair using Figure of 8 Locking Stitch
P2 flail repaired with individual ePTFE neochords.
A Conversation on measuring chords.
P2 Repair using Leipzig Loop Technique (ChordX)
Measuring the Distance
P3 + P2 repair (Decalcification of P3 and Leipzig Loop P2)
P2 Flail repair using triangular resection
P2 Flail repair using Triangular resections
P1 flail/prolapse
P1 Repair with Adjustable Multi chord system using Figure of 8 Locking Stitch
P1 and P2 Prolapse repaired with pre-measured chordal system
Posterior valve pathology - P3 flail/prolapse
P2 repair with pre-measured chords, massive prolapse
Anterior valve pathology - A2 flail/prolapse
A2 Repair using Leipzig Loop technique
A2 Repair using Adjustable ChordX system and Figure of 8 Locking Stitch
A2 Redo Repair using Fibrillatory Arrest
A3 flail/prolapse
A1 flail/prolapse
A1 Repair as part of multi-segment Pathology
A1, P1 Repair after Healed Endocarditis
A3 repair figure of 8 locking wV
P1, A1 repair after healed endocarditis wV
Bileaflet Pathology - Barlow's Disease
Bileaflet Prolapse (functional, non Barlow's)
Bileaflet Prolapse (functional, non Barlow's) Repair with Large Complete Ring
Barlow's Valve Repair with Large Complete Ring
Barlow's Valve Repair with posterior leaflet neochordae
A2, A3, P2, P3 Repair using Neochordal Reconstruction
Sizing the Mitral Annulus
Placing the annuloplasty sutures during a repair
Mitral Valve Replacement
The rheumatic mitral valve replacement
Mechanical MVR in severe rheumatic mitral disease
External suture control and prosthesis anchoring.
The calcified mitral valve and Mitral Annular Calcification (MAC)
MVR in severe annular calcification
MVR in Endocarditis Complicating MAC
MVR in Severe MAC using Ultrasonic Aspiration
TAVR in MAC Minimally Invasive
Tricuspid Valve Repair
Tricuspid Valve Repair in a Massive Right Atrium
Tricuspid Valve Replacement
Tricuspid Valve Repair Concomitant to Mitral Valve Replacement
Tricuspid valve replacement
Complex Tricuspid valve repair with Encased RV lead
Tricuspid valve replacement
Tricuspid repair isolated
MVR with concomitant TVrepair
Redo MVR TVRepair massive LA
Right ventricular permanent epicardial lead placement minimally invasive
Atrial Septal Defects
Patent Foramen Ovale Closure
Large ASD with mitral valve repair performed through it followed by patch closure of the defect.
Minimally Invasive Cryoablation
Box Lesion performed minimally invasive with MVR
PVI performed minimally invasive with MVR
Endoscopic Box lesion with anterior leaflet repair
Left Atrial Appendage Management
Left atrial appendage closure.
Benign Tumor Resection
Left atrial myxoma resection and mitral valve repair
Tasks before closure
Left atrial closure and deairing.
Before Closing
Femoral decannulation
Postoperative Management
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