A Case of Successfully Managed Expectations for Minimally Invasive Mitral Valve Repair (Video)

A 56-year-old man underwent echocardiography at an outside institution to investigate a heart murmur. It revealed mitral valve regurgitation with a flail posterior leaflet; the regurgitation was later confirmed to be severe. The patient was a healthcare provider who worked in an operating room setting.

He was referred to Cleveland Clinic for transcathether mitral valve repair with the MitraClip® procedure despite having no comorbidities and being active and in good health apart from the mitral regurgitation. Since MitraClip is indicated solely for patients at prohibitive risk from surgery, the Cleveland Clinic interventional cardiology team advised him that MitraClip was not an appropriate option.

The patient had hoped to avoid open surgery, but workup showed that he was a candidate for robotically assisted mitral valve repair. He was heartened by the prospect of this less-invasive option, although his cardiothoracic surgeon, Stephanie Mick, MD, cautioned that conversion to an open repair is always a possibility if unexpected issues are encountered in the operating room.

In this three-and-a-half-minute captioned video, Dr. Mick walks through key steps in this patient’s robotically assisted repair procedure, including a handful of small innovative techniques that she highlights throughout.