PANORAMITRA: a novel polyetheretherketone-based perivalvular tissue retractor for use in minimally invasive and conventional cardiac surgery

In degenerative mitral valve surgery, repair typically involves annuloplasty, resection ofdiseased segments, and neochordal implantation for leaflet resuspension. However,subvalvular exposure, particularly of the papillary muscles, remains technicallychallenging under minimally invasive approaches—especially in patients withredundant leaflet tissue. Here, we describe the clinical application of “PANORAMITRA,” (Senko MedicalInstrument Mfg. Co., Ltd., Tokyo, Japan) a novel perivalvular retractor originally designed and developed by our surgical team, made of medical-gradepolyetheretherketone (PEEK). The device can be easily deployed through a mini-thoracotomy and precisely positioned within the mitral annulus to facilitate subvalvular visualization. Key words