Robotic mitral valve repair of anterior leaflet perforation and ruptured chordae with EndoDirect cannulation

This is a video showing the technique I used to treat a patient with severe MR related to an old perforation of the anterior leaflet of the mitral valve and ruptured chordae. EndoDirect aortic cannulation with a side arm was used to avoid retrograde perfusion due to PVD and distal aortic atheroma. This also facilitates passage of the EndoClamp aortic catheter occlusion of the ascending aorta, aortic root venting, delivery of antegrade cardioplegia. Retrograde cardioplegia was also used as is routine. An autologous gluteraldehyde pericardial patch was used to repair the perforation of the leaflet after debriding the edges. The ruptured chordae were repaired with Goretex and annuloplasty was then performed to complete the repair.