Abstract
After 30 years since its introduction, the edge-to-edge technique has become one of the most popular and adopted worldwide for surgical repair of mitral regurgitation. The success of this procedure could possibly be explained by its unique simplicity and high level of reproducibility. Indeed, it possesses the ability of being very versatile and it has been used in a wide spectrum of mitral valve pathologies and lesions: from degenerative to functional disease, from posterior to anterior leaflet lesions, including commissural defects. The rapidity of this easy surgical gesture has also enhanced its application in minimally invasive approaches. Finally, it has become a true milestone for the era of transcatheter correction of mitral regurgitation. Here, we describe the history and evolution of this breakthrough in the world of cardiac surgery.
Highlights
Mitral valve disease still represents the most frequent valvulopathy[1]
In 1991, the Italian cardiac surgeon Professor Ottavio Alfieri introduced a surgical technique for the repair of mitral regurgitation, named “edge-to-edge”[6]
Despite the uncertainties of a new surgical procedure, Professor Alfieri obtained the informed consent from the patient and an efficient mitral valve repair was achieved with the novel “Alfieri’s Edge-to-Edge” technique
Summary
Mitral valve disease still represents the most frequent valvulopathy[1]. Several studies have shown the preference of valve repair over replacement due to reduced peri-operative mortality and improved longterm survival, becoming the gold standard for treatment of severe degenerative mitral regurgitation (MR)[2]. As stated by the 2017 ESC guidelines on the treatment of valvular heart disease, surgery (especially repair whenever possible) is indicated in cases of severe symptomatic primary mitral valve regurgitation with left ventricle ejection fraction > 30%[2].
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