title: Transapical off-pump mitral valve repair. First experience with the NeoChord system in Poland (report of two cases).
abstract: BACKGROUND
  Artificial chord implantation to repair a flail or prolapsing mitral valve leaflet requires open heart surgery and cardiopulmonary bypass.
  
  
  OBJECTIVE
  Transapical off-pump artificial chordae implantation is a new surgical technique proposed to treat degenerative mitral valve regurgitation. The procedure is performed using the NeoChord DS1000 system (NeoChord, Inc., St. Louis Park, MN, USA), which facilitates both implantation and lenght adjustment of the artificial chordae under two (2D)- and three (3D)-dimensional transoesophageal echocardiographic (TEE) guidance on a beating heart.
  
  
  METHODS
  Two male patients aged 60 and 55 years with severe mitral regurgitation due to posterior leaflet prolapse underwent transapical off-pump artificial chordae implantation on September 3, 2015. The procedure was performed by left minithoracotomy under general anaesthesia in a cardiac surgical theatre, using 2D and 3D TEE guidance.
  
  
  RESULTS
  Early procedural success as confirmed by 3D TEE was achieved in both patients, with implantation of 6 artificial chordae in the first patient and 3 artificial chordae in the second patient. Both procedures were uneventful, and no postoperative complications were noted. The patients were discharged home on the 8th and 6th postoperative day, respectively.
  
  
  CONCLUSIONS
  The NeoChord DS1000 system allows both implantation and lenght adjustment of artificial chordae under 2D and 3D TEE guidance on a beating heart. Our initial experience in 2 patients with posterior mitral leaflet prolapse indicates that the procedure is feasible and safe.
authors.affiliation: Medicover Hospital, Warsaw, Poland. krzysztof.wrobel17@gmail.com.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wróbel
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kurnicka
authors.forename: Marcin
authors.initials: M
authors.lastname: Zygier
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dyk
authors.forename: Ryszard
authors.initials: R
authors.lastname: Wojdyga
authors.forename: Dariusz
authors.initials: D
authors.lastname: Zieliński
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Jarzębska
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Juraszyński
authors.forename: Barbara
authors.initials: B
authors.lastname: Lichodziejewska
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
authors.forename: Andrzej
authors.initials: A
authors.lastname: Biederman
authors.forename: Giovanni
authors.initials: G
authors.lastname: Speziali
authors.forename: Uwe
authors.initials: U
authors.lastname: Kasten
mesh_terms: D002815:Chordae Tendineae / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000150:complications / Q000601:surgery*; D011044:Poland; D016896:Treatment Outcome
keywords: NeoChord; artificial chordae; mitral valve repair; severe mitral regurgitation