Review of the endovascular approach to mitral valve disease

Abstract

The first interventional attempts at relieving mitral valve disease were in a sense minimally invasive, using relatively small incisions and introduction of instruments or a finger to open stenotic valves on the beating heart. The development of reliable cardiopulmonary bypass (CPB) made exact anatomic repair of mitral pathology possible with improved results. Mitral valve surgery on an arrested heart has been the mainstay of treatment for decades. Modifications and minimalization of the surgical approach using videoscopic or robotic instruments have made less invasive procedures possible. Such procedures demand excellent technical skills and are still not widely adopted. More recently, attempts have been made to repair mitral valves using endovascular access on the beating heart, guiding the repair process with real-time imaging. We are presenting a review of available and developing techniques for endovascular repair of the mitral valve. A device developed by our group will be briefly described.

Key words:

• Advanced technology
• cardiac surgery
• catheter interventions
• endovascular therapy
• instrument design

Declaration of interest: The authors are developing an instrument for repair of the mitral valve. The instrument is presently used only for research and is briefly mentioned in this article. The authors alone are responsible for the content and writing of the paper.