Room Setup

High-definition monitors should be positioned across from the surgeon and the assistant, allowing all members of the surgical team to view the endoscopic image throughout the procedure.

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Patient Positioning

The optimal patient positioning for the µMVR™ procedure is supine, with both arms tucked and a right infrascapular roll placed to elevate the right hemithorax by approximately 20°.

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multiSTATION® System Setup‍

Mounted directly to the table rails over the drape, the multiSTATION® System provides a modular, readily adjustable platform for holding the endoscope, LSI’s customized equipment, and other surgical instruments during the procedure.

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Pericardial Stay Suture Management

After opening the pericardium, retraction sutures are held using the low-profile RaPort™ Device, which is inserted through the chest wall with a blunt obturator to minimize trauma and bleeding.

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Tensioning Stay Sutures

The miniRUMEL® Device provides for secure and readily-adjustable control of tension for venous, arterial, and purse string stay sutures.

Atriotomy

An atriotomy into the left atrium provides a clear pathway to the mitral valve annulus.

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Mitral Annular Exposure

Retractors help expose, align, and stabilize the mitral annulus and the subvalvular apparatus, facilitating enhanced visualization.

Atriotomy

An atriotomy into the left atrium provides a clear pathway to the mitral valve annulus.

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Mitral Annular Exposure

Retractors help expose, align, and stabilize the mitral annulus and the subvalvular apparatus, facilitating enhanced visualization.

Atriotomy

An atriotomy into the left atrium provides a clear pathway to the mitral valve annulus.

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Mitral Annular Exposure

Retractors help expose, align, and stabilize the mitral annulus and the subvalvular apparatus, facilitating enhanced visualization.

Annular Suturing

The RAM® Device shaft rotates and its tip angulates for ergonomic suture bite placement. Available with either 3.5 or 5.0 mm needle spacing, the RAM® Device uses dual curved needles to place the first half of a horizontal mattress suture with a single squeeze and release of the lever. After each bite, the RAM® sutures are transferred to the SEW-EASY® Cassette for the next step. RAM® annular suturing follows a pattern to minimize potential obstruction of endoscopic visualization.

Prosthetic Suturing

A single squeeze and release of the SEW-EASY® lever places both suture ends through the prosthetic valve sewing cuff at widths of either 3.5 or 5.0 mm. The assistant typically loads the cassette into the SEW-EASY® Device. The surgeon holds the prosthtic valve on a customized handle during suture palcement to enable rapid and precise control of this critical step.

Suture Securing

The COR-KNOT® Device promptly, reliably, and ergonomically secures valve sutures while providing multiple clinically demonstrated benefits to patients. Titanium fasteners have replaced the need for the hand-tying of over 20 million sutures. The COR-KNOT® approach enhances the surgeon’s ability to pursue the preferred “no-touch” principle in valve replacement.