Transapical off‐pump mitral valve repair with NeoChord implantation: A systematic review

Abstract

Introduction: Mitral valve repair (MVr) is the gold standard for the treatment of degenerative mitral valve regurgitation (MR). The recently introduced NeoChord DS1000 has gained increasing recognition as a feasible, potentially safe, and effective procedure with minor complications and promising outcomes. This study aims to conduct a systematic review of the published literature that discusses the technical feasibility and outcome of transapical off-pump MVr with NeoChord DS1000 device implantation in the treatment of degenerative MR. Methods: This review was performed according to the PRISMA statement. Databases searched in this review included Pubmed, Web of Science, Scopus, and Cochrane databases for systematic reviews. All English articles on humans reporting isolated MVr using NeoChord DS1000 device were included provided that basic preoperative data, operative specifications, and postoperative mortality and morbidity were reported. Results: This review included six studies comprised 249 patients who had NeoChord mitral procedure. Almost all patients included had severe MR (243/249, 97.6%). Operative success was achieved in 241 out of the 249 patients (96.8%). No intraoperative mortality was reported. Intraoperative arrhythmia was reported in six patients (2.4%) and significant bleeding was reported in eight patients (3.2%). Conclusion: Awaiting more evidence, NeoChord mitral procedure appears to be a promising procedure that can be considered in selected cases.

Case report: Recurrent severe mitral regurgitation due to ruptured artificial chords after transapical Neochord mitral valve repair

“…Off-pump transapical Neochord mitral valve repair has been proven to be a technically safe and achievable procedure to correct MR from grade 3+/4+ to ≤ 2+ ( 5 ). Type A or type B anatomy which featured isolated-/multi-segments prolapse or flail of the posterior mitral leaflet was considered the optimized selection for Neochord implantation.…”

Transapical off-pump mitral valve repair following prior mitral valve surgery

“…In a large European registry as well as in a recent meta-analysis, it has been shown that mitral valve repair with the NeoChord system was safe, feasible and durable with a low perioperative morbidity. [10,11] As it is a "ringless" procedure, a certain length of the leaflets has to be ensured to enable the grasping with the NeoChord device and to allow for the proper coaptation of the leaflets after fixation of the neo-chordae. This limitation must be considered when selecting patients.…”

Left Ventricular Apex: A “Minimally Invasive Motorway” for Safe Cardiovascular Procedures

“…Ahmed et al systematically reviewed the published literature on transapical beatingheart mitral valve repair with Neochord [36], and identified six studies covering a total of 249 patients. The operative success rate was 96.8% and the 30-day mortality rate was 1.9%.…”