Why the study?
Surgical fixation after recurrent regurgitation following mitral repair is technically demanding and carries high morbidity and mortality, making strategies that avoid adhesive sites or cardiopulmonary bypass desirable.
Off-pump neochordae implantation via left minithoracotomy may be a feasible and safe alternative for treating recurrent mitral regurgitation after previous surgical repair, avoiding the risks of reopening the sternum and cardiopulmonary bypass.
May reduce reoperative risk in select recurrent MR cases; leaves open need for prospective safety and efficacy data.
Surgical fixation after recurrent regurgitation following surgical mitral repair has been technically demanding and associated with high morbidity and mortality. Avoiding reopening the adhesive site or limiting the usage of cardiopulmonary bypass are solutions for reducing the operative risk. We report a case of recurrent mitral regurgitation treated by off-pump neochordae implantation via left minithoracotomy. A 69-year-old woman with a history of conventional mitral repair via median sternotomy developed heart failure due to mitral regurgitation from recurrent posterior leaflet P2 prolapse. Four neochordaes were implanted off-pump via left minithoracotomy using a NeoChord DS1000 in the seventh intercostal space. No transfusion was required. The patient was discharged a week after the procedure with no complications. The regurgitation remains trivial 6 months after the NeoChord procedure.
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Seguchi et al. (2023) studied this question.
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