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Ann Cardiothorac Surg. 2018 Nov;7(6):812-820. doi: 10.21037/acs.2018.11.04.

Transapical NeoChord mitral valve repair.

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Department of Cardiology, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.


Transapical off-pump mitral valve repair (MVr) with NeoChord implantation has become widely applied in Europe for patients presenting with severe mitral regurgitation due to leaflet prolapse or flail. The procedure is performed under real-time 2D- and 3D-transesophageal echocardiography (TEE) for both implantation and neochordae tension adjustment allowing real-time monitoring of hemodynamic recovery. Preoperative anatomic and echocardiographic selection criteria, procedure refinement, as well as innovative ex-vivo surgical simulator training have been developed and strategically employed in the past few years, to generate a robust precision-based procedural framework with significantly enhanced operator use, patient safety and clinical outcomes. The procedure has evolved into a reproducibly successful and safe approach, which complements existing surgical treatment strategies available to eligible patients with chronic severe degenerative mitral regurgitation.


Mitral regurgitation; NeoChord; mitral insufficiency; mitral valve flail; mitral valve prolapse; mitral valve repair (MVr)

Conflict of interest statement

Conflicts of Interest: A Colli, G Gerosa received travel grants from Neochord, Inc. D Adams is the Co-Principal Investigator of the Rechord Trial, which is supported by Neochord, Inc. The other authors have no conflicts of interest to declare.

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