Off-pump Transapical Mitral Valve Repair with Implantation of Neo-chordae

2011 ◽  
Vol 7 (3) ◽  
pp. 181
Author(s):  
Michael Hoebartner ◽  
Philipp Kiefer ◽  
Michael Andrew Borger ◽  
Friedrich Wilhelm Mohr ◽  
Joerg Seeburger ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Beating Heart ◽  
Severe Mitral Regurgitation ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Off Pump ◽  
Repair Procedure ◽  
Artificial Chordae

The authors present a case report of a mitral valve repair procedure featuring beating-heart, sternal-sparing implantation of neo-chordae. The 73-year-old female patient had severe mitral regurgitation (MR) pre-operatively, but no MR post-operatively and at 30-day follow-up. The patient was enrolled in the Transapical artificial chordae tendineae (TACT) trial sponsored by NeoChord Inc.

scholarly journals Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study

2009 ◽  
Vol 137 (1) ◽  
pp. 188-193 ◽  
Author(s):  
Pietro Bajona ◽  
William E. Katz ◽  
Richard C. Daly ◽  
Kenton J. Zehr ◽  
Giovanni Speziali
Keyword(s):  
Mitral Valve ◽  
Animal Study ◽  
Mitral Valve Repair ◽  
Beating Heart ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Off Pump ◽  
Artificial Chordae

scholarly journals Optimizing P2 Neochordal Length and Stability in Mitral Valve Repair With Use of a Polypropylene Loop

2020 ◽  
Vol 47 (3) ◽  
pp. 207-209
Author(s):  
Anil Ozen ◽  
Ertekin Utku Unal ◽  
Hamdi Mehmet Ozbek ◽  
Gorkem Yigit ◽  
Hakki Zafer Iscan
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Severe Mitral Regurgitation ◽  
Posterior Leaflet ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Optimal Length ◽  
Precise Method ◽  
Artificial Chordae

Determining the optimal length of artificial chordae tendineae and then effectively securing them is a major challenge in mitral valve repair. Our technique for measuring and stabilizing neochordae involves tying a polypropylene suture loop onto the annuloplasty ring. We used this method in 4 patients who had moderate-to-severe mitral regurgitation from degenerative posterior leaflet (P2) prolapse and flail chordae. Results of intraoperative saline tests and postoperative transesophageal echocardiography revealed only mild insufficiency. One month postoperatively, echocardiograms showed trivial regurgitation in all 4 patients. We think that this simple, precise method for adjusting and stabilizing artificial chordae will be advantageous in mitral valve repair.

scholarly journals Actual perspective on off-pump transapical artificial chord implantation

2021 ◽  
Author(s):  
Andrea Colli
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
High Volume ◽  
Mitral Valve Surgery ◽  
Valve Repair ◽  
Transfemoral Approach ◽  
Off Pump ◽  
Artificial Chordae ◽  
Small Cohort

Mitral valve repair (MVR) is undisputedly associated with better clinical and functional outcomes than any other type of valve substitute. Conventional mitral valve surgery in dedicated high-volume centers can assure excellent results in terms of mortality and freedom from mitral regurgitation (MR) recurrence but requires cardiopulmonary bypass (CPB) and cardioplegic heart arrest. Trying to replicate the percentage of success of surgical MVR is the aim of all new transcatheter mitral dedicated devices. In particular transapical beating-heart mitral valve repair by artificial chordae implantation with transesophageal echocardiography (TEE) guidance is an expanding field. The safety and feasibility of the procedure have already been largely demonstrated with Neochord and more recently with Harpoon systems. Wang et al. present the outcomes of the first-in-human experience using a novel artificial chordae implantation device, the Mitralstitch system. Despite a quite small cohort of only 10 patients treated, 1-year results are satisfying and comparable to the early experience with former devices (4 patients with moderate or more MR recurrence). The comparison with surgical MVR is still unfavorable and requires further studies and significant procedure improvement. However, the device permits the treatment of anterior and posterior leaflets prolapse and performs quite easily edge-to-edge reparation. It will be interesting to evaluate longer follow-up in larger cohorts of patients as well as the possibility to shift to the transfemoral approach.

A mitral annulus tracking approach for navigation of off-pump beating heart mitral valve repair

2014 ◽  
Vol 42 (1) ◽  
pp. 456-468 ◽  
Author(s):  
Feng P. Li ◽  
Martin Rajchl ◽  
John Moore ◽  
Terry M. Peters
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Annulus ◽  
Beating Heart ◽  
Valve Repair ◽  
Off Pump

scholarly journals Recurrent mitral regurgitation after mitral valve repair for bileaflet lesions in the modern era

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Daisuke Kaneyuki ◽  
Hiroyuki Nakajima ◽  
Toshihisa Asakura ◽  
Akihiro Yoshitake ◽  
Chiho Tokunaga ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Late Phase ◽  
Severe Mitral Regurgitation ◽  
Valve Repair ◽  
Sequential Approach ◽  
Posterior Mitral Leaflet ◽  
Quadrangular Resection

Abstract Background Good mid-term durability of mitral valve repair of bileaflet lesions has been reported; however, patients may develop failure during follow-up. This study assessed late outcomes and mechanisms of failure associated with mitral valve repair of bileaflet lesions. Methods Fifty-six patients (mean age 67 ± 12 years) underwent mitral valve repair of bileaflet lesions due to degenerative disease in 2011–2018. Mitral annuloplasty was added to all procedures except for 1 patient with annular calcification. Mitral valve lesions were identified by surgical inspection. Mean clinical and echocardiography follow-up occurred at 2.7 ± 2.1 and 2.5 ± 1.9 years, respectively. Results Additional mitral valve repair techniques involved triangular resection (n = 15 patients), quadrangular resection with sliding plasty (n = 12), neochordoplasty (n = 52), and commissural plication (n = 26). Prolapse of ≥2 anterior and posterior leaflet scallops occurred in 22 (39%) and 30 (54%) patients, respectively. During follow-up, 10 (17.8%) patients developed moderate or severe mitral regurgitation. Whereas prolapse or tethering was observed early after neochordoplasty or quadrangular resection, recurrent regurgitation occurred late after commissural repair. Five-year freedom from recurrent moderate or severe mitral regurgitation rates was 71.1 ± 11.0%. Conclusions Seventeen percent of patients developed recurrent mitral regurgitation during follow-up. Repair failure in the early phase occurred owing to aggressive resection of the posterior mitral leaflet or maladjustment of the artificial neochordae. Recurrent mitral regurgitation might occur in the late phase even after acceptable commissural repair. A sequential approach may be useful to improve the quality of mitral valve repair in bileaflet lesions.

Idiopathic Acute Mitral Regurgitation Due to Chordal Rupture in Infants: Surgical Management and Results

2019 ◽  
Vol 10 (1) ◽  
pp. 37-41
Author(s):  
Kosuke Yoshizawa ◽  
Keiichi Fujiwara ◽  
Nobuhisa Ohno ◽  
Kentaro Watanabe ◽  
Hisanori Sakazaki
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Surgical Intervention ◽  
Valve Repair ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Acute Mitral Regurgitation ◽  
Artificial Chordae

Objective: Emergency surgical treatment is required for idiopathic acute mitral regurgitation due to chordae rupture in infants. Nevertheless, mitral valve repair for such a patient population still remains challenging. We report our experience with mitral valve repair for idiopathic acute mitral regurgitation due to chordae rupture in infants. Methods: From 2005 to 2017, six infants (four boys) were diagnosed with acute mitral regurgitation due to chordae rupture and underwent mitral valve repair. The median age, mean body weight, and median follow-up period were 5.5 months (range: 4-9 months), 6.8 kg (range: 5.5-8.0 kg), and 6.4 years (range: 6 months to 10 years), respectively. Results: In all cases, surgical intervention was performed within 24 hours of admission. Artificial chordae reconstruction and paracommissural edge-to-edge repair were utilized in three and four cases, respectively, while Kay’s annuloplasty was performed in all cases. Mean cardiopulmonary bypass time and aortic cross-clamp time were 117 minutes (range: 70-143 minutes) and 73 minutes (range: 35-108 minutes), respectively. No early or late deaths and reoperations had occurred during the follow-up period. Moreover, postoperative mitral regurgitation was significantly reduced, while no chronologic progression of mitral regurgitation was observed. Conclusions: The combination of various techniques, such as artificial chordae reconstruction, paracomissural edge-to-edge repair, and Kay’s annuloplasty, can be a promising surgical option for idiopathic acute mitral regurgitation due to chordae rupture in infants.

scholarly journals Clinical results of mitral valve repair by reconstructing artificial chordae tendineae in children

1999 ◽  
Vol 118 (1) ◽  
pp. 94-98 ◽  
Author(s):  
Takashi Matsumoto ◽  
Hideaki Kado ◽  
Munetaka Masuda ◽  
Yuichi Shiokawa ◽  
Kouji Fukae ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Clinical Results ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Artificial Chordae

scholarly journals Feasibility of novel transapical off pump beating heart mitral valve repair in a patient with dextrocardia and situs inversus

2020 ◽  
Vol 58 (2) ◽  
pp. 392-394
Author(s):  
Inderjeet Bhatia ◽  
Daniel Tai-Leung Chan ◽  
Simon Chi-Cheung Lam ◽  
Timmy Wing-Kuk Au
Keyword(s):  
Mitral Valve ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Situs Inversus ◽  
Beating Heart ◽  
Invasive Technique ◽  
Valve Repair ◽  
Off Pump ◽  
Mitral Repair

Abstract We present a case to demonstrate the feasibility of transapical beating heart mitral valve repair in a patient with dextrocardia. This minimally invasive technique provides simple, safe and satisfactory mitral repair. The surgical technique, outcome and prognosis are not affected by the condition.

scholarly journals Transapical Beating-Heart Mitral Valve Repair Using a Novel Artificial Chordae Implantation System

2018 ◽  
Vol 106 (5) ◽  
pp. e265-e267 ◽  
Author(s):  
Shouzheng Wang ◽  
Xu Meng ◽  
Zhiling Luo ◽  
Xiangbin Pan
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Beating Heart ◽  
Valve Repair ◽  
Artificial Chordae
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