The first four cases of successful NeoChord procedure in Chinese mainland

doi:10.5847/wjem.j.1920-8642.2019.03.001

Abstract

Abstract:

BACKGROUND: Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in Chinese mainland.
METHODS: Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE).
RESULTS: Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge.
CONCLUSION: The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.

Key words: Mitral regurgitation, Mitral valve repair, NeoChord system

Li-han Wang, Zhao-xia Pu, Min-jian Kong, Ju-bo Jiang, Kai-da Ren, Feng Gao, Xin-ping Lin, Lei Yu, Wei He, Min Yan, Xian-bao Liu, Jian-an Wang. The first four cases of successful NeoChord procedure in Chinese mainland[J]. World Journal of Emergency Medicine, 2019, 10(3): 133-137.

Figures/Tables 3

Table 1

Figure 1.

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References 14

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Patient	ID	Age (years)	Gender	NYHA	CAD	COPD	Hypertension	Diabetes	LVEF (%)	LVEDD (cm)	MR grade	Leaflet involvement	Leaflet prolapse
Patient 1	10659216	86	Male	IV	Y	Y	N	N	51.1	5.06	Severe	P2	Y
Patient 2	10800079	84	Male	IV	Y	N	N	N	68.0	4.26	Severe	P2	Y
Patient 3	11297740	80	Female	III	Y	N	N	N	72.7	5.41	Severe	P2	Y
Patient 4	03145944	60	Male	II	N	N	N	N	72.3	4.77	Severe	P2	Y

Variables	Patient 1	Patient 2	Patient 3	Patient 4
ID	10659216	10800079	11297740	03145944
MR
Preoperative	Severe	Severe	Severe	Severe
Intraoperative	Mild	Mild	Moderate	Mild
Pre-discharge	Mild	Mild	Moderate	Mild
One-month follow-up	Mild	Mild	Moderate	Mild
LVEF (%)
Preoperative	51.6	68	72.7	72.3
Pre-discharge	40.9	73.5	66.1	57.3
One-month follow-up	53.7	61.4	64.6	55.7
LVEDD (cm)
Preoperative	5.06	4.26	5.41	4.77
Pre-discharge	4.82	4.08	5.20	4.88
One-month follow-up	5.30	3.69	4.93	5.06
Complications
Pre-discharge	Transient AF	N	Transient AF	N
One-month follow-up	N	N	N	N