International Society For Minimally Invasive Cardiothoracic Surgery

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Transventricular Cardioscopic Release Of A Trapped Prosthetic Mitral Valve Leaflet
Nicholas J. S. Chilvers, MB BChir MA(Cantabs), Sankar Balasubramanian, Muhammad Mydin, Denis O'Leary, Simon Leddingham, Stephen Clark.
Freeman Hospital, Newcastle Upon Tyne, United Kingdom.

OBJECTIVE: To share this novel approach to a complex situation.
METHODS: A 68 year old male had previously undergone an AVR in 2006. Subsequently he required a re-do AVR and root replacement in 2016 but this was complicated by worsened MR, resulting in the need for a salvage MVR via thoracotomy. Unfortunately this was further complicated by a trapped valve leaflet. He recovered well initially but represented with worsening heart failure. Due to the high risk of sternotomy, a transventricular cardioscopic release of the trapped mitral valve leaflet was undertaken.
RESULTS: The procedure was successful and the patient discharged home on day 12.
CONCLUSIONS: This is a novel minimally invasive approach for high risk patients with this rare complication. This technique is carried out using small incisions and negates the need for myocardial ischaemia. We hope by sharing it others will consider this approach in the future.

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