Mitral Valve Repair of the Medial Commissure Through an Upper Mini Sternotomy

In this video Dr. Vince Gaudiani demonstrates how to perform an Onyx Chord-X chordal repair of a prolapsing medial commissure of the mitral valve in a 44-year-old woman with severe mitral regurgitation.    

He first cannulated the femoral vein, then performed an upper mini sternotomy before placing a right superior pulmonary vein vent and performing aortic cannulation with antegrade cardioplegia. The roof of the left atrium was then opened, and stay sutures were placed to optimize the view.  

Before assessing the valve, all the annuloplasty sutures were placed. Upon assessment of the valve, the medial commissure was found to be billowing anteriorly and posteriorly, so it was sutured together. The Onyx Chord-X depth gauge was then used to measure the height needed for the chords, and three sets of chords were placed to secure the anterior and posterior leaflets medially, resulting in an excellent repair. 

After this, a 35mm posterior annuloplasty ring was placed, and the atrium was closed to conclude the procedure.   

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