Reintervention for recurrence of mitral valve regurgitation: Transventricular beating heart neochordae implantation versus on-pump surgery

Objective: Recurrence of mitral valve regurgitation after prior repair remains a challenge, even in experienced centers. Reoperation is associated with increased morbidity and mortality risks, prompting the exploration of less-invasive alternatives. This study aimed to compare outcomes in patients with failed mitral valve repair undergoing on-pump surgery versus micro-invasive re-repair surgery using neochordae (the NeoChord system). Methods: Thirty-seven patients were retrospectively enrolled; 22 patients underwent on-pump surgery, and 15 patients underwent NeoChord repair. All patients had recurrent mitral valve prolapse after prior annuloplasty. The primary end point was freedom from a composite event, defined as mitral valve reoperation or the presence of moderate-or-severe mitral regurgitation at 1 year. All patients provided informed written consent for the publication of their data. Results: 0001). Follow-up echocardiographic findings and cardiovascular readmissions were comparable between the 2 groups. Conclusions: In patients with recurrent prolapse after mitral valve repair, NeoChord re-repair offers comparable 1-year outcomes to on-pump surgery, with significantly faster recovery and reduced transfusion needs.