High-Fidelity Minimally Invasive Mitral Valve Repair Simulator

Mitral valve repair is one of the most complicated and difficult procedures in cardiac surgery due to the complexity of the mitral valve and diversity of its pathology. Performing mitral valve repair through minimally invasive techniques (whether endoscopically, through direct vision, or with robotic-assistance) is even more difficult.

Minimally invasive mitral valve repair (MIMVR) has been shown to be effective and beneficial for patients, but the application of this technique has been concentrated in high-volume centers and in the hands of a limited number of surgeons. Dexterity in open surgery is insufficient for starting a MIMVR, as a new dexterity must be developed. The most critical technical steps are working with long-shafted instruments endoscopically and placing sutures on the mitral valve annulus. Therefore, the learning curve of MIMVS is steep and unfortunately still developed in patients.

The author has developed and designed a minimally invasive mitral valve simulator with the help of the engineering department at Maastricht University Medical Center (MUMC), the Netherlands. This simulator will enable residents, fellows, and surgeons to develop skills in MIMVR, and practice those skills endlessly.

These simulators were successfully used for the first time during the EACTS course, Minimally Invasive Techniques in Adult Cardiac Surgery, held in Maastricht during June 2014.