Minimally Invasive Mitral Valve Surgery Using the FlexCrown Retractor: A Safe and Effective New Self-Expandable Left Atrial Exposure Device

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Minimally Invasive Procedures

Background:

• Minimally invasive mitral valve surgery (MIMVS) requires optimal visualization for valve assessment.
• Conventional left atrial retractors can be time-consuming and may cause complications like bleeding.
• There is a need for improved retraction devices in MIMVS.

Purpose of the Study:

• To evaluate the safety and efficacy of the FlexCrown™ self-expandable left atrial retractor.
• To assess its performance in minimally invasive mitral valve surgery (MIMVS).

Main Methods:

• Retrospective analysis of 245 patients undergoing MIMVS.
• Utilized the Geister FlexCrown™ retractor via right minianterolateral thoracotomy.
• Data collected from January 2017 to July 2022 across two mitral specialist centers.

Main Results:

• The FlexCrown retractor showed no instances of tissue damage, dislodgement, or migration.
• Postoperative echocardiograms indicated no or trivial mitral regurgitation in 90% of patients.
• The device facilitated both mitral valve repair (125 patients) and replacement (120 patients).

Conclusions:

• The FlexCrown retractor provides excellent and safe mitral valve exposure during MIMVS.
• Its fast deployment and removal offer an advantage over conventional retractors.
• This innovative device is a potentially valuable alternative for MIMVS procedures.