What does this research mean for the field?

Aberrantly inserted chordae tendineae can cause significant mitral valve dysfunction, which can be successfully treated with surgical excision, neochord reconstruction, and annuloplasty. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the rare presentation of aberrant chordae tendineae causing mitral regurgitation and the surgical intervention required.

February 19, 2026Portuguese Journal of Cardiac Thoracic and Vascular SurgeryOpen Access

Misconnected: Valve Failure from an Unexpected Chordal Insertion

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: 64-year-old woman with severe mitral regurgitation secondary to aberrantly inserted mitral valve chordae tendineae causing heart failure symptoms (n=1). Intervention: Surgical excision of aberrant chordae tendineae with reconstruction using polytetrafluoroethylene (Gore-Tex) neochords and annuloplasty. Primary outcome: Mitral valve function assessed intraoperatively by transesophageal echocardiography, specifically residual mitral regurgitation severity.

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Key result

Surgical excision of aberrant chordae with neochord reconstruction and annuloplasty successfully restores mitral valve function.

Population

A 64-year-old woman with heart failure secondary to severe mitral regurgitation

Design

Case report

Authors

CNCatarina Relvas NovoAdministração Regional de Saúde de Lisboa e Vale do Tejo MCMariana CamposAdministração Regional de Saúde de Lisboa e Vale do Tejo PNPaulo NevesAdministração Regional de Saúde de Lisboa e Vale do Tejo

Discussion

Member takes

Implication

Supports feasibility of repair for rare aberrant chordae MR; hypothesis-generating and should not yet change practice.

Key Points

To investigate the rare presentation of aberrant chordae tendineae causing mitral regurgitation and the surgical intervention required.
Patient evaluation with transthoracic echocardiography (TTE) to assess mitral regurgitation
Intraoperative inspection following atriotomy to identify chordal abnormalities
Surgical correction with excision of aberrant chordae and placement of Gore-Tex neochords
Mitral annuloplasty ring placement to complete repair
Postoperative evaluation using transesophageal echocardiography to assess valve function
Successful excision of aberrant chordae tendineae
Confirmation of improved valve function with minimal residual regurgitation
Uneventful postoperative recovery with discharge on day four following surgery

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 64-year-old woman with heart failure symptoms secondary to severe mitral regurgitation.

Intervention

Mitral valve repair including excision of the aberrant chord, reconstruction with polytetrafluoroethylene (Gore-Tex) neochords, and placement of a mitral annuloplasty ring.

Outcome

Valve function and clinical recovery

Aberrant chordae tendineae inserting into the left atrial wall is a rare cause of severe mitral regurgitation that can be successfully treated with surgical valve repair.

Limitations

Single patient report limits generalizability.
Lack of long-term follow-up data to assess durability of repair.
No comparator or control group available in this case.

Cite This Study

Novo et al. (2025) conducted a case report in 64-year-old woman with severe mitral regurgitation secondary to aberrantly inserted mitral valve chordae tendineae causing heart failure symptoms (n=1). Surgical excision of aberrant chordae tendineae with reconstruction using polytetrafluoroethylene (Gore-Tex) neochords and annuloplasty was evaluated on Mitral valve function assessed intraoperatively by transesophageal echocardiography, specifically residual mitral regurgitation severity. Surgical excision of the aberrant chordae with neochord reconstruction and annuloplasty achieved excellent valve function with only minimal residual mitral regurgitation and an uneventful recovery in a 64-year-old woman.

synapsesocial.com/papers/6996a887ecb39a600b3ef539 https://doi.org/10.48729/pjctvs.575

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Misconnected: Valve Failure from an Unexpected Chordal Insertion

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Misconnected: Valve Failure from an Unexpected Chordal Insertion

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider