Mitral valve repair is one of the most complicated and difficult procedures in cardiac surgery due to the complexity of the mitral valve and diversity of its pathology. Performing mitral valve repair through minimally invasive techniques (whether endoscopically, through direct vision, or with robotic-assistance) is even more difficult. Minimally invasive mitral valve repair (MIMVR) has been shown to be effective and beneficial for patients, but the application of this technique has been concentrated in high-volume centers and in the hands of a limited number of surgeons.
Dexterity in open surgery is insufficient for starting a MIMVR, as a new dexterity must be developed. The most critical technical steps are working with long-shafted instruments endoscopically and placing sutures on the mitral valve annulus. Therefore, the learning curve of MIMVR is steep
and unfortunately still developed in patients.

Stand-alone high-fidelity mitral valve simulator

The simulator can be used for the following surgical approaches:

• MIMVR endoscopically
• MIMVR through direct vision
• MIMVR with robotic-assistance using the
  available ports
• Conventional mitral valve repair by opening
  the thorax

• The mitral valve component is disposable and developed from special material that mimics the tissue characteristics of the mitral valve so that a
  true suturing experience can be created
• The simulator gives feedback about the exact depth and length of each suture.
• The simulator provides a picture of each suture.
• The depth and length of each suture attempt can be pre-setted and the simulator will provide feedback about the suture attempt with regard
  to pre-setted values.
• The disposable papillary muscles for suturing the neochordae are available.
• The disposable mitral valve can theoretically be replaced by a 3D-printed mitral valve of an individual patient for pre-operative practice and
  pre-planning of complex mitral valve repair.