Good 5-Year Durability of Transapical Beating Heart Off-Pump Mitral Valve Repair With Neochordae

Kiefer, Philipp; Meier, Sabine; Noack, Thilo; Borger, Michael A.; Ender, Joerg; Hoyer, Alexandro; Mohr, Friedrich W.; Seeburger, Joerg

doi:10.1016/j.athoracsur.2018.01.092

Cited by 50 publications

(51 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MVr with the NeoChord procedure has been shown to provide incremental benefit for the acute volumetric reduction of the left ventricle and atrium in this patient population, followed by the concomitant improvement in MV geometry immediately following trans-apical replacement of ruptured or elongated chordae with the NeoChord technology. These observations have been sustained in late follow-up periods (17)(18)(19).…”

Section: Commentsmentioning

confidence: 75%

Transapical NeoChord mitral valve repair

Colli

Adams

Fiocco

et al. 2018

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

Transapical off-pump mitral valve repair (MVr) with NeoChord implantation has become widely applied in Europe for patients presenting with severe mitral regurgitation due to leaflet prolapse or flail. The procedure is performed under real-time 2D-and 3D-transesophageal echocardiography (TEE) for both implantation and neochordae tension adjustment allowing real-time monitoring of hemodynamic recovery. Preoperative anatomic and echocardiographic selection criteria, procedure refinement, as well as innovative ex-vivo surgical simulator training have been developed and strategically employed in the past few years, to generate a robust precision-based procedural framework with significantly enhanced operator use, patient safety and clinical outcomes. The procedure has evolved into a reproducibly successful and safe approach, which complements existing surgical treatment strategies available to eligible patients with chronic severe degenerative mitral regurgitation.

show abstract

Section: Commentsmentioning

confidence: 75%

Transapical NeoChord mitral valve repair

Colli

Adams

Fiocco

et al. 2018

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

show abstract

“…Mitral valve repair is the preferred treatment for patients with severe degenerative mitral valve regurgitation resulting from prolapsed mitral leaflets with or without chordal rupture. The NeoChord procedure is an innovative microinvasive, transventricular, beating‐heart chordal replacement technique that is designed to replace ruptured or elongated chordae tendinae on the prolapsing segment of a mitral valve leaflet with artificial chordae made of expanded polytetrafluoroethylene (ePTFE) . The artificial chordae or neochordae are placed on the mitral leaflet, while the heart is beating using the DS1000 System (NeoChord, Inc St. Louis Park, MN).…”

mentioning

confidence: 99%

Use of a photo‐realism 3D rendering technique to enhance echocardiographic visualization of the anatomical details during beating‐heart mitral valve repair

et al. 2019

View full text Add to dashboard Cite

Mitral valve repair is the preferred treatment for patients with severe degenerative mitral valve regurgitation resulting from prolapsed mitral leaflets with or without chordal rupture. The NeoChord procedure is an innovative microinvasive, transventricular, beating-heart chordal replacement technique that is designed to replace ruptured or elongated chordae tendinae on the prolapsing segment of a mitral valve leaflet with artificial chordae made of expanded polytetrafluoroethylene (ePTFE). 1-3 The artificial chordae or neochordae are placed on the mitral leaflet, while the heart is beating using the DS1000 System (NeoChord, Inc St. Louis Park, MN). The DS1000 system is introduced via a transventricular approach through the distal, posterolateral wall of left ventricle. Preprocedure, use of three-dimensional (3D) transoesophageal (TOE) imaging is crucial for optimal patient selection. In addition, 3D TOE is critical for procedural navigation of the device and to confirm ePTFE chordal placement and positioning on the mitral leaflet. Awareness of the morphological details of the prolapsed mitral leaflet segment is an important consideration when assessing patient selection. However, understanding the change in morphological characteristics of the mitral leaflet segments during the procedure is also a key driver for successful outcomes. Use of real time 3D, with single beat acquisition, allows for visualization of the valvular anatomy and any related structural dysfunction with near-instantaneous volume-rendered reconstructions.Additionally, this 3D rendering technique avoids spatial motion artifacts by acquiring 3D volumetric datasets without requiring the need of cardiac or respiratory gating, single beat acquisition of datasets, that is, possible thanks to matrix phased-array transducer technology that includes the use of thousands of transmit-receive elements to generate the image volume. As such, real time 3D TOE

show abstract

“…With the advent of transcatheter procedures, that are designed to treat valvular heart disease, an innovative micro‐invasive, trans‐ventricular, beating‐heart chordal replacement technique was developed. The NeoChord procedure has been reported as safe and effective …”

mentioning

confidence: 99%

“…The NeoChord procedure has been reported as safe and effective. [1][2][3][4] The NeoChord procedure is performed using the DS1000 system (NeoChord, Inc.). The NeoChord device is introduced through a posterolateral ventriculotomy and advanced toward the mitral valve The importance of neochordae placement location along the leaflet margin has been previously described for a novel technique of beating-heart, anterior mitral leaflet augmentation, which is also performed using the DS1000 device.…”

mentioning

confidence: 99%

“The Starry Sky.” A new intraprocedural three‐dimensional echocardiographic technique

Vairo

Marro

Speziali³

et al. 2019

Echocardiography

View full text Add to dashboard Cite

The NeoChord procedure is a micro‐invasive, trans‐ventricular, beating‐heart chordal replacement technique for patients with severe degenerative mitral valve regurgitation resulting from prolapsed or flail leaflets. Three dimensional transoesophageal echocardiographic guidance is crucial to assist the operator during the procedure. Equidistant placement of neochordae along the free edge of the prolapsing leaflet segment is important to ensure uniform stress distribution and to avoid damaging any of the previously placed neochordae. Lowering the image gain associated with the three‐dimensional surgical view of the mitral valve allows for signal attenuation of the native structures delineating the precise placement location of the neochordae.

show abstract

Good 5-Year Durability of Transapical Beating Heart Off-Pump Mitral Valve Repair With Neochordae

Cited by 50 publications

References 17 publications

Transapical NeoChord mitral valve repair

Transapical NeoChord mitral valve repair

Use of a photo‐realism 3D rendering technique to enhance echocardiographic visualization of the anatomical details during beating‐heart mitral valve repair

“The Starry Sky.” A new intraprocedural three‐dimensional echocardiographic technique

Contact Info

Product

Resources

About