Page 553 - Read Online

Belluschi et al. Mini-invasive Surg 2020;4:58 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.48

Review Open Access

The Alfieri’s edge-to-edge technique for mitral valve
repair: from a historical milestone of cardiac surgery

to the origin of the transcatheter era

Igor Belluschi, Nicola Buzzatti, Alessandro Castiglioni, Ottavio Alfieri, Michele De Bonis

Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan 20132, Italy.

Correspondence to: Dr. Igor Belluschi, Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele
University, Via Olgettina 60, Milan 20132, Italy. E-mail: belluschi.igor@hsr.it
How to cite this article: Belluschi I, Buzzatti N, Castiglioni A, Alfieri O, De Bonis M. The Alfieri’s edge-to-edge technique for mitral
valve repair: from a historical milestone of cardiac surgery to the origin of the transcatheter era. Mini-invasive Surg 2020;4:58.
http://dx.doi.org/10.20517/2574-1225.2020.48

Received: 18 May 2020 First Decision: 23 Jun 2020 Revised: 28 Jun 2020 Accepted: 10 Jul 2020 Published: 1 Sep 2020
Academic Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

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.

Keywords: Mitral valve repair, edge-to-edge technique, Alfieri’s stitch, double-orifice

INTRODUCTION
[1]
Mitral valve disease still represents the most frequent valvulopathy . Several studies have shown the
preference of valve repair over replacement due to reduced peri-operative mortality and improved long-
term survival, thus becoming the gold standard for treatment of severe degenerative mitral regurgitation
[2]
(MR) . At the beginning of the 1980’s, Professor Alain Carpentier introduced the so-called “French

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.misjournal.net