{"title":"房室管部分修复后再手术微创内镜二尖瓣修复。","authors":"Satoshi Arimura, Michael W A Chu","doi":"10.1510/mmcts.2025.080","DOIUrl":null,"url":null,"abstract":"<p><p>Re-operation following previous congenital heart repair can be challenging. We present a 38-year-old female with a history of partial atrioventricular septal defect repair in infancy who developed severe mitral regurgitation due to a cleft anterior mitral leaflet. Given her anatomy and prior sternotomy, we performed a redo minimally invasive endoscopic mitral valve repair via right anterolateral minithoracotomy access. We meticulously closed the cleft using precise suture placement to restore leaflet integrity and function and performed an annuloplasty to reinforce the annulus and optimize leaflet coaptation. The minimally invasive approach minimized surgical trauma, while endoscopic visualization allowed for a precise and effective repair. This case highlights the feasibility of this approach in patients with complex congenital heart disease, offering a viable alternative to sternotomy with potential benefits for both short- and long-term outcomes.</p>","PeriodicalId":53474,"journal":{"name":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","volume":"2025 ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Re-operative minimally invasive endoscopic mitral valve repair after partial atrioventricular canal repair.\",\"authors\":\"Satoshi Arimura, Michael W A Chu\",\"doi\":\"10.1510/mmcts.2025.080\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Re-operation following previous congenital heart repair can be challenging. We present a 38-year-old female with a history of partial atrioventricular septal defect repair in infancy who developed severe mitral regurgitation due to a cleft anterior mitral leaflet. Given her anatomy and prior sternotomy, we performed a redo minimally invasive endoscopic mitral valve repair via right anterolateral minithoracotomy access. We meticulously closed the cleft using precise suture placement to restore leaflet integrity and function and performed an annuloplasty to reinforce the annulus and optimize leaflet coaptation. The minimally invasive approach minimized surgical trauma, while endoscopic visualization allowed for a precise and effective repair. This case highlights the feasibility of this approach in patients with complex congenital heart disease, offering a viable alternative to sternotomy with potential benefits for both short- and long-term outcomes.</p>\",\"PeriodicalId\":53474,\"journal\":{\"name\":\"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery\",\"volume\":\"2025 \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1510/mmcts.2025.080\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multimedia manual of cardiothoracic surgery : MMCTS / European Association for Cardio-Thoracic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1510/mmcts.2025.080","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Re-operation following previous congenital heart repair can be challenging. We present a 38-year-old female with a history of partial atrioventricular septal defect repair in infancy who developed severe mitral regurgitation due to a cleft anterior mitral leaflet. Given her anatomy and prior sternotomy, we performed a redo minimally invasive endoscopic mitral valve repair via right anterolateral minithoracotomy access. We meticulously closed the cleft using precise suture placement to restore leaflet integrity and function and performed an annuloplasty to reinforce the annulus and optimize leaflet coaptation. The minimally invasive approach minimized surgical trauma, while endoscopic visualization allowed for a precise and effective repair. This case highlights the feasibility of this approach in patients with complex congenital heart disease, offering a viable alternative to sternotomy with potential benefits for both short- and long-term outcomes.
期刊介绍：
The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
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