Evaluation of residual mitral regurgitation after robot-assisted mitral valve repair using the focused 3D method: a report of two cases

Abstract Background Rapid and accurate intraoperative assessment of residual mitral regurgitation (MR) after robot-assisted mitral valve repair is essential, although identifying its etiology using conventional two-dimensional transesophageal echocardiography (2D-TEE) can be challenging. We report two cases in which the Focused 3D Method facilitated intraoperative assessment of residual MR. Case presentation Two male patients underwent robot-assisted mitral valve repair for severe MR. The Focused 3D Method enabled accurate identification of the location and mechanism of residual MR. In one patient, the findings prompted a second pump run to correct a previously unrecognized A1 prolapse. In the other, the technique demonstrated shallow leaflet coaptation, supporting the decision to avoid reintervention. Both patients had favorable postoperative outcomes. Discussion The Focused 3D Method may improve intraoperative assessment of residual MR and support decision-making regarding the need for a second pump run after mitral valve repair.