Transapical NeoChord mitral valve repair

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Echocardiography

Background:

• Severe mitral regurgitation (MR) due to leaflet prolapse or flail is a significant clinical problem.
• Transapical off-pump mitral valve repair (MVr) with NeoChord implantation offers a minimally invasive option.
• The widespread adoption in Europe highlights its growing clinical acceptance.

Purpose of the Study:

• To describe the evolution and application of transapical off-pump MVr with NeoChord implantation.
• To outline the procedural framework, including selection criteria and training.
• To emphasize the impact on operator use, patient safety, and clinical outcomes.

Main Methods:

• Real-time 2D and 3D transesophageal echocardiography (TEE) for implantation and tension adjustment.
• Development of preoperative selection criteria and procedural refinement.
• Innovative ex-vivo surgical simulator training for operators.

Main Results:

• The procedure has evolved into a reproducibly successful and safe approach.
• Enhanced operator use, patient safety, and clinical outcomes have been achieved.
• Successful hemodynamic recovery is monitored in real-time.

Conclusions:

• Transapical off-pump MVr with NeoChord implantation is a viable and effective treatment for severe degenerative MR.
• The precision-based procedural framework ensures safety and improves outcomes.
• This technique complements existing surgical strategies for eligible patients.