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Mitral Valve Repair Fellowship

The Fellowship offers candidates the opportunity to learn key aspects of mitral valve surgery from expert leaders. This includes understanding when surgery is indicated, the benefits of mitral valve repair versus replacement, and mastering various surgical approaches (full sternotomy, minimally invasive, and endoscopic). Candidates will also learn how to target specific mitral lesions, apply appropriate repair techniques, and manage common valve-related complications. Mitral valve repair is highlighted as a crucial skill for cardiac surgeons, capable of restoring normal life expectancy when performed timely and effectively. Preoperative planning and surgical expertise are vital for achieving optimal outcomes, including low mortality and long-term freedom from recurrent regurgitation. Training in high-volume centers with a strong tradition in mitral valve repair offers invaluable hands-on learning and insights from experienced surgeons.
Acquired Cardiac Disease

Summary

  • Application Dates

    1st March – 1st May 2025

  • Grant

    €3,750

  • Location

    San Raffaele Heart Valve Centre, Milan, Italy

  • Duration

    2 weeks

  • Start Date

    From January 2026

Fellowship Overview

This Fellowship offers a 2-week full immersion in a high volume centre with long-standing experience in mitral valve repair. We provide the opportunity to join our daily multidisciplinary Heart Team meetings to discuss complex cases, and to attend our operating rooms. Clinical practice routinely takes place from Monday to Friday, with 4 to 6 surgical cases daily and 4-5 transcatheter procedures 2-3 days/week. For FFF candidates, individual case discussion with expert surgeon and imagers will be also available daily.

Learning Objectives

  • Indication and timing of mitral surgery to correct severe mitral regurgitation
  • Knowledge of the main mitral valve repair techniques
  • Knowledge of different available surgical approaches
  • Troubleshooting of the most common valve-related and approach-related complications

Specific Learning Objectives

  • Mastering tips and tricks to perform an effective durable repair
  • Identify the most effective repair technique in each proposed anatomical setting
  • Learning cornerstone of minimally invasive and endoscopic approaches

Syllabus

  • Indications to mitral valve surgery and why mitral valve repair, when feasible, is a better option if compared with mitral valve replacement: a deep dive into 2021 ESC/EACTS guidelines for valvular heart disease
  • Pre-operative planning: trans-esophageal echocardiography for cardiac surgeons
  • Pre-operative planning: the role of cardiac CT scan in patients undergoing minimally invasive mitral valve repair
  • Pre-operative planning: the adjunctive role of other techniques (MRI, stress echocardiography…) in selected contexts
  • Surgical pitfalls in mitral valve repair
  • How to perform the intra-operative mitral valve analysis
  • Tips and tricks of mitral valve annuloplasty
  • How to deal with posterior leaflet pathology
  • Resect (quadrangular/triangular resection) vs respect approach
  • Techniques to decrease posterior leaflet height (sliding vs folding vs butterfly)
  • How to deal with anterior leaflet pathology: neochordal implantation vs edge to edge technique
  • The challenges of bileaflet prolapse and how to deal with it
  • Bailout techniques in case of persistent mitral regurgitation after mitral valve repair
  • Systolic anterior motion (SAM) of anterior mitral leaflet:
    – Pre-operative risk factors
    – How to prevent SAM during mitral valve repair
    – How to treat post-operative SAM (conservative measures vs second pump run)
  • The effects of mitral valve surgery on ventricular arrhythmias in patients with Barlow’s disease: how to recognize, risk-stratify and treat patients at increased arrhythmic risk

Funding

To help with living and travel costs associated with this Fellowship, we offer a grant of €3,750. EACTS will also provide a bursary towards the cost of your attendance at the 2026 EACTS Annual Meeting.

Application and Selection

In order to apply for this fellowship there are some essential criteria you must meet:

  • The applicant should be a trainee in the last 2 years of training who demonstrates an in depth understanding of general cardiothoracic surgery
  • Be an EACTS member with up-to-date membership payment
  • Be fluent in English

Applicants who possess the following desirable criteria would be of particular interest:

  • A highly motivated individual who has engaged with EACTS and demonstrates potential that will be useful in his institutional and wider practice

In order to complete your application, you must submit the following documents*:

  • Letter of support from applicant’s home institution
  • Letter of interest (detailing how you are able to apply the skills and knowledge obtained during the Fellowship in your own centre)
  • Curriculum Vitae (CV)
  • Operative experience

*Please ensure that all documents submitted are written in English, and that they are submitted either as word documents or PDF. We do not accept images or handwritten applications.  We are unable to provide advice or guidance about visa applications, so please ensure that you understand the visa requirements before applying for this Fellowship.

Evaluation and Feedback

Written feedback with a structured evaluation of learning activities to the participating leaders.

At the end of the Fellowship, the Fellows will produce a full report on their experience based on the Francis Fontan Fund Committee guidelines.

Terms and Conditions