# Innovative Mitral Valve Repair Using a Novel Automated Suturing System: Preliminary Data

## TL;DR

A new automated suturing system was tested for mitral valve repair, showing promise in reducing surgical complexity and time.

## Contribution

The study introduces a novel automated suturing system for mitral valve repair using a modified Roman Arch technique.

## Key findings

- The modified Roman Arch repair was successfully completed on ten human heart specimens with an average repair time of 3:01 minutes.
- 90% of the attempts were rated as satisfactory or very satisfactory, indicating technical feasibility.
- Repair times showed a trend toward reduction as surgeon experience increased.

## Abstract

(1) Background and Objectives: Mitral regurgitation is a common valve disease requiring surgical repair. Even with satisfactory results, repair techniques may underlie subjectivity and variability and require long learning curves. A novel approach, the “Roman Arch” technique, may ease the technical burden. This study assessed an automated suturing device’s feasibility and time efficiency for a proposed simplified technique. (2) Materials and Methods: Using the MiStitch™ and MiKnot™ devices (LSI Solutions, Inc., Victor, NY, USA), the suture pattern was performed in a cadaver model. Three surgeons with different expertise levels conducted the procedures. Repair and suture placement times were recorded and analyzed. (3) Results: The modified “Roman Arch” repair was completed on all ten human heart specimens with an average total repair time of 3:01 ± 00:59 min and a trend toward reduced times as experience increased. The study confirmed the technical feasibility with 90% of the attempts rated as rather satisfactory or very satisfactory. (4) Conclusions: The MiStitch™ system effectively facilitated the modified “Roman Arch” repair in an ex vivo setting, suggesting its potential to reduce the technical complexity of mitral valve repairs. Further studies are needed to confirm its efficacy and safety in clinical practice.