Modified Intraoperative Saline Injection Leak Test to Assess Mitral Valve Repair

Background: Intraoperative trans-esophageal echocardiography (TEE) and Saline injection pressurization of the left ventricle are the most popular methods to evaluate the repaired mitral valve during mitral valve repair surgery. We describe a simple and reliable intraoperative saline injection leak test method for mitral valve repair which has multiple benefits over the conventional method. Materials and methods: Twenty patients with mitral regurgitation who met the inclusion criteria for mitral valve repair were enrolled in the study. When the repair procedure is done, a balloon catheter (12 Fr Foley catheter) is inserted into the left ventricle through the site of cardioplegia cannula on ascending aorta and inflated at the level of left ventricular outflow tract inferior to the aortic valve. The valve’s competency is then evaluated by saline injection into the left ventricle through the balloon catheter. Results: Intra operative TEE revealed trivial and mild MR in 12 and 7 patients and moderate MR in one patient. No significant discrepancy was found between the intra-operative TEE findings and the described intra-operative leak test results (p value 0.05). Conclusion: The intraoperative saline leak test described here is a simple, safe and reliable method to assess the efficacy of mitral valve repair before chest closure