5. Echocardiographic Assessment of Minimally Invasive Mitral Valve Repair - Dr. Massimiliano Meineri

Objectives
1. Describe the utility of intraoperative TEE in minimally invasive mitral valve repair.
2. Outline a structured approach for MV assessment repair, highlighting specific measurements for MIS techniques
3. Explain the use of TEE to detect unexpected intraoperative complications requiring immediate remedy in minimally invasive mitral valve repair.

References
Nicoara A, Skubas N, Ad N, Finley A, Hahn RT, Mahmood F, et al. Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach. Journal of the American Society of Echocardiography. 2020 Jun;33(6):692–734. https://doi.org/10.1016/j.echo.2020.0...
Carpentier A. Cardiac valve surgery--the “French correction.” J Thorac Cardiovasc Surg. 1983 Sep;86(3):323–37. https://doi.org/10.1016/S0022-5223(19...
Mahmood F, Sharkey A, Maslow A, Mufarrih SH, Qureshi NQ, Matyal R, et al. Echocardiographic Assessment of the Mitral Valve for Suitability of Repair: An Intraoperative Approach From a Mitral Center. J Cardiothorac Vasc Anesth. 2021 Jul 3;S1053-0770(21)00569-3. https://doi.org/10.1053/j.jvca.2021.0...
Case discussion applying Mahmood, Sharkey et al. framework:    • Ischemic Mitral Regurgitation  
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jun 10;63(22):e57–185. https://doi.org/10.1016/j.jacc.2014.0...
2017 Update: https://doi.org/10.1016/j.jacc.2017.0...
Maslow AD, Regan MM, Haering JM, Johnson RG, Levine RA. Echocardiographic predictors of left ventricular outflow tract obstruction and systolic anterior motion of the mitral valve after mitral valve reconstruction for myxomatous valve disease. J Am Coll Cardiol. 1999 Dec;34(7):2096–104. https://doi.org/10.1016/S0735-1097(99...
Heart base TEE Valve Map - CC-BY 4.0 from: https://docs.google.com/presentation/...
Varghese R, Itagaki S, Anyanwu AC, Trigo P, Fischer G, Adams DH. Predicting systolic anterior motion after mitral valve reconstruction: using intraoperative transoesophageal echocardiography to identify those at greatest risk. Eur J Cardiothorac Surg. 2014 Jan;45(1):132–7; discussion 137-138. https://doi.org/10.1093/ejcts/ezt234

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