Mitral valve repair. Surgical techniques and approaches

Mitral valve regurgitation is the second most common valvular heart disease in western countries. Depending on the etiology a differentiation is made between primary and secondary mitral valve regurgitation. Primary mitral valve regurgitation can be treated by various operative techniques via different surgical access points; however, currently, minimally invasive surgery is usually preferred in specialized centers to the full sternotomy approach and providing equally good surgical results. Current operative standards involve cusp-preserving techniques, e.g. by the use of artificial tendon threads as replacement for chordae tendineae rather than resection of parts of the leaflets. The treatment of secondary mitral valve regurgitation essentially depends on an interdisciplinary teamwork approach and is increasingly performed using interventional techniques.