Double Transapical Access During Neochord Implantation

Mitral valve repair using transapical off-pump beating-heart neochordae implantation is a relatively new procedure with promising early and mid-term results in selected patients. Nevertheless, early failures a few days after the procedure, requiring surgical reintervention, have been described. We describe a case of intraoperative acute procedural failure treated with a second procedure through a different transapical access adjacent to the first one. The final result was excellent with trivial residual regurgitation and the subsequent hospitalization was uneventful. This case demonstrates that a second transapical mitral neochordae implantation is feasible and should be considered in case of intraoperative acute procedural failure.