A Mitral Valve Repair Update: "Corset" Technique

Please explain the educational or technical point that this video addresses.: Modern Mitral Valve repair techniques, albeit comprehensive and validated, may not be entirely objective, allow space for speculation on where to pass the artificial cords, and may leave out fine nuances of the pathology, such as asymmetry of the neighbouring scallops, clefts or incisures or commissural lesions. As in management of any complex system, variability impedes performance and outcome, so in mitral valve repair, variability may impact the result both positively, but also negatively. Also, each surgeon may walk out with a different degree of residual regurgitation, despite same pathology. Here we introduce the "Corset" technique, featuring one single running suture. This simplified, standardised and intuitive method of mitral valve repair, which utilises less cords, eliminates variability to some extent, and may facilitate reproducible repair with lesser effort, while addressing multiple pathologies, at the discretion of the surgeon.

Please provide a 250 word summary of the surgical video being submitted.: Often, there is a need to reduce the posterior leaflet and tether it towards the annulus, particularly in concurrent annular dysfunction and hyper-motility. This is often seen in Barlows’ disease, forme-frustae, and other forms of excessive leaflet and annular motility. Here, the artificial cord needle enters through the margin of the prolapsing segment and exits trans-annular, below the leaflet. The stitch may or may not pass through the corresponding papillary muscle (PM). This can be repeated 1, 2, or 3 times, through the respective segments, and exit trans-annular, into the atrium and tied there onto a pledget or the ring itself. This can take care of extensive length prolapse, or singular segment prolapse, provide synchronicity of PM, free margin and also reduce Barlow’s by targeted, partial annuloplasty.