Transcatheter mitral valve replacement (TMVR) is a therapeutic option for patients with severe mitral disease who are deemed inoperable due to their overall surgical risk. The close relationships between the left ventricular outflow tract (LVOT) and the anterior mitral valve leaflet can lead to LVOT obstruction, a common complication with high mortality. Predicting and preventing LVOT obstruction is therefore essential, prior to TMVR. Laceration of the Anterior Mitral leaflet to Prevent Outflow ObtructioN (LAMPOON) is a transcatheter electrosurgical technique to split the anterior mitral valve leaflet immediately prior to TMVR. The technique has been studied in a prospective clinical trial and has evolved with many iterations for specific anatomies. In this review, we discuss the different LAMPOON techniques to prevent and treat LVOT obstruction.
  Minimally invasive cardiac surgery is an attractive approach for both surgeons and patients. This study aims to describe the experience of mitral valve replacement (MVR) with Ma's tri-port totally thoracoscopic cardiac surgery technique (MTCST) and to prove the feasibility and safety of this technique.
 
  A total of 490 consecutive patients undergoing MVR were divided into MTCST group (MT group, n=267) and conventional median sternotomy group (MS group, n=223). The perioperative characteristics and the follow-up information were recorded and analyzed between the two groups.
 
  The in-hospital mortality and re-operation rate were not significant between the two groups. Compared with the MS group, cardiopulmonary bypass time and aortic cross-clamp time were both longer in the MT group while total operative time was similar to the MS group. Patients in the MT group had less pain and required a decreased analgesic administration than that in the MS group. Intraoperative blood loss, perioperative blood transfusion and the postoperative drainage were all significantly reduced in the MT group as compared to the MS group. Mechanical ventilation time, ICU duration, hospitalization time and hospitalization cost were decreased in the MT group. Patients undergoing MVR with MTCST had a higher Medical Treatment Satisfactory Score than those with conventional sternotomy.
 
  MTCST for mitral valve disease was technically safe and feasible. The results showed that MTCST was a suitable minimally invasive alternative to the conventional sternotomy approach and was a desirable approach for patients with mitral valve disease.
 MTCST for mitral valve disease was technically safe and feasible. The results showed that MTCST was a suitable minimally invasive alternative to the conventional sternotomy approach and was a desirable approach for patients with mitral valve disease.
  Reductive annuloplasty repair of ischemic mitral regurgitation (IMR) is associated with high rates of recurrent MR, which may be improved with etiology-specific annuloplasty rings.
 
  From October 2005 to May 2015, 128 consecutive patients underwent repair of IMR with the GeoForm ring. Clinical data was extracted from our local Society of Thoracic Surgeons database and electronic medical records. Mortality data was obtained from the Michigan State Social Security Death Index.
 
  The average age of patients was 65±11 years with mean pre-op left ventricular ejection fraction (LVEF) of 30%±10% and MR grade of 3.1±0.9 (0-4+). Thirty-day mortality was 4.7%, rate of renal failure 7.9%, rate of atrial fibrillation 27.3%, and no strokes were observed. Of the surviving patients, 89% (109/122) had a follow-up echocardiogram beyond 1 month with a mean echocardiographic follow-up of 59±39 months. LVEF improved from 30%±10% to 38%±14%, P<0.001) while end-diastolic (5.9±0.0 to 5.3±0.9 cm, P<0.001) and end-systolic (5.0±1.0 to 4.4±1.1 cm, P<0.001) left ventricular (LV) diameters decreased, as compared to pre-operative values. Seven patients were found to have recurrent moderate or greater IMR in follow-up to 10 years with three being due to ring dehiscence. One-, 5-, and 10-year freedom from recurrent moderate or severe IMR was 98%, 94%, and 80% respectively. One-, 5-, and 10-year survival was 91%, 77%, and 44%, respectively.
 
  Overall, etiology-specific ring repair of IMR was associated with low rates of recurrent MR on long-term follow-up, coupled with significant LV reverse remodeling and improvement in ejection fraction.
 Overall, etiology-specific ring repair of IMR was associated with low rates of recurrent MR on long-term follow-up, coupled with significant LV reverse remodeling and improvement in ejection fraction.
  The NeoChord echo-guided transapical beating heart repair is a promising early-stage minimally invasive surgical procedure for degenerative mitral valve (MV) regurgitation (DMR) correction. The technique has been improved since its inception following procedure standardization, patient selection optimization, and learning curve stabilization. We hereby present the mid-term clinical results through three years of our large single center experience.
 
  All consecutive patients with severe symptomatic DMR due to prolapse or flail of one or both mitral leaflets that underwent the NeoChord procedure between November 2013 and June 2019 were included. Patients were categorized according to MV anatomy; Type A isolated central posterior leaflet prolapse and/or flail, Type B posterior multi-segment prolapse and/or flail, Type C anterior and/or bi-leaflet prolapse or flail, Type D paracommissural prolapse and/or flail and/or significant leaflet and/or annular calcifications. Patients underwent clinical and echocardiogrw-up patient success was 81.2%±3.8% and 32 patients (64%) had a residual MR mild or less (1+).  https://www.selleckchem.com/products/trastuzumab.html  Patient success was significantly different according to anatomical type (P=0.001). Echocardiographic analysis showed a significant acute left ventricle and left atrial reverse remodeling that was maintained up to three years.
 
  The NeoChord echo-guided transapical beating heart repair procedure demonstrated good clinical outcomes and echocardiographic results up to three-year follow-up.
 The NeoChord echo-guided transapical beating heart repair procedure demonstrated good clinical outcomes and echocardiographic results up to three-year follow-up.