Format

Send to

Choose Destination

See 1 citation found by title matching your search:

J Thorac Cardiovasc Surg. 2014 Jan;147(1):95-9. doi: 10.1016/j.jtcvs.2013.08.012. Epub 2013 Oct 5.

Off-pump transapical implantation of artificial chordae to correct mitral regurgitation: early results of a single-center experience.

Author information

1
Department of Cardiovascular Medicine, Vilnius University, Vilnius, Lithuania.
2
Department of Cardiovascular Medicine, Vilnius University, Vilnius, Lithuania. Electronic address: janvilius@yahoo.com.
3
Centre of Anaesthesia, Intensive Care, and Pain Management, Department of Intensive Care, Vilnius University, Vilnius, Lithuania.
4
Department of Cardiothoracic Surgery, University of Pittsburgh Physicians, Pittsburgh, Pa.

Abstract

OBJECTIVES:

This study evaluated the safety and efficiency of the NeoChord DS1000 system (NeoChord, Inc, Minneapolis, Minn), a device designed to deliver artificial chordae tendineae (neochords) in a beating heart with minimally invasive techniques through left anterolateral minithoracotomy.

METHODS:

Thirteen patients with severe mitral regurgitation and isolated posterior mitral valve leaflet prolapsed underwent operation with the NeoChord DS1000 system. Mitral valve dimensions were anteroposterior 34 mm (29-45 mm) and mediolateral 40 mm (29-58 mm). All patients had an ejection fraction greater than 55%. With a beating heart, through a left anterolateral thoracotomy, under transesophageal echocardiographic guidance, the NeoChord DS1000 was introduced into the left ventricle 2 to 4 cm posterolateral from the apex. The prolapsed leaflet was grasped with the device, and expanded polytetrafluoroethylene suture deployed and attached to the posterior leaflet. Six patients received 2 sutures, 4 received 3 sutures, and 2 received 4 sutures. All patients reached 6 months' follow-up and underwent transthoracic echocardiography to evaluate mitral regurgitation.

RESULTS:

Median operative duration was 113 minutes (80-150 minutes). Less than second-degree mitral regurgitation in 6 months was achieved in 11 patients (85%). One patient (8%) had recurrent mitral regurgitation in 1 month, and another had conversion to conventional mitral valve repair because of leaflet damage with the device. There were no further serious procedure-related complications.

CONCLUSIONS:

Beating-heart transapical neochord implantation was feasible, could be performed safely, and resulted in a relatively short procedure time. Larger studies and longer follow-up are needed to validate these promising results.

KEYWORDS:

28; 35.4.1; LV; MR; TACT; TEE; Transapical Artificial Chordae Tendineae [trial]; left ventricle; mitral regurgitation; transesophageal echocardiography

Comment in

PMID:
24100100
DOI:
10.1016/j.jtcvs.2013.08.012
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center