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Off-pump transapical implantation of artificial chordae to correct mitral regurgitation: Early results of a single-center experience

Selected in Journal of Thoracic Cardiovascular Surgery by S. Head

References

Authors

Rucinskas K, Janusauskas V, Zakarkaite D, Aidietiene S, Samalavicius R, Speziali G, Aidietis A

Reference

J Thorac Cardiovasc Surg 2014;147:95-99

Published

January 2014

Link

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My Comment

Results

  • Through 12/2011 - ¬†08/2012, 13 patients with isolated posterior mitral valve leaflet prolapse underwent off-pump transapical neochord delivery with the NeoChord DS1000 system (NeoChord, Inc, Minneapolis, Minn, USA).
  • Follow-up was completed at 6 months.
  • Successful implantation was achieved in 92% of patients. One patient was converted to open mitral valve repair. Intraoperative¬† was trivial in 84% of patients and 1+ in 16%.
  • At 6 months, 11/13 patients had <2+ MR. Average LV end-diastolic diameter was reduced from 58mm to 53mm (P=0.002), and LV end-systolic diameter remained 35mm. Left atrial volume decreased from 69 to 55 mL/m2 (P=0.004). No major adverse cardiac events were reported over 6-month follow-up.

My comments

Data on the NeoChord device are very limited, and the study by Rucinskas and co-authors show that procedural success can be achieved in nearly all patients, MR can significantly be reduced to a satisfactory degree in the majority of patients, and the procedure has no to minimal complications. However, this was a single-center study with only a small sample size, and more experience is required to ensure the safety and efficacy of the NeoChord device. Furthermore, it will be necessary to see whether the degree of MR remains <2+ over longer follow-up, although these data out to 6 months are promising.

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