The first four cases of successful NeoChord procedure in Chinese mainland

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 artifi cial 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 artifi cial chordae in the fi rst patient and 3,2,and 3 artifi cial 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 fi nding 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.

经食管超声心动图引导NeoChord人工腱索治疗二尖瓣后叶脱垂合并重度反流的初步研究

目的:初步探讨经食管超声心动图引导NeoChord人工腱索治疗二尖瓣后叶脱垂合并重度反流的应用价值。方法:选取2019年4-7月浙江大学医学院附属第二医院8例二尖瓣后叶脱垂合并重度反流的NeoChord人工腱索植入术的患者,NeoChord人工腱索植入前经食管超声心动图详细评估二尖瓣形态、脱垂位置及反流程度;植入术中经食管超声全程指导穿刺部位、人工腱索植入路径并调节腱索长度;植入后评估人工腱索位置,评估反流程度的改善情况,且手术全程监测有无并发症的发生。结果:8例患者分别植入人工腱索2~4根,术中即刻经食管超声心动图和出院前经胸超声心动图提示患者术后轻度残余反流5例,中度残余反流2例,轻-中度残余反流1例,术中术后均无并发症发生;术后1个月经胸超声心动图复查示轻度反流6例,中度反流2例。结论:NeoChord人工腱索植入术是二尖瓣脱垂引起的二尖瓣重度反流患者的安全、有效、易操作的治疗方式,经食管超声心动图在人工腱索植入过程中起着重要的指导作用。