RE-INTERVENTION AFTER FAILED MITRAL VALVE REPAIR WITH RING: TRANS-VENTRICULAR BEATING HEART NEOCHORD IMPLANTATION VS STANDARD SURGERY

Background and Aim: Recurrence of mitral regurgitation (MR) due to leaflet prolapse after mitral valve repair (MVr) may lead to re-intervention, with high risk of morbidity and mortality and challenging re- repair. The aim is to compare the results of patients with failed MVr with annuloplasty that underwent NeoChord or standard surgery. Methods: Between 2006 and 2024, 36 patients were retrospectively enrolled: 14 underwent NeoChord, group A; 22 where reoperated through right mini-thoracotomy (13) or sternotomy (9), group B. There was no statistically significant difference in terms of age (67±4.9 vs 64±9.9), gender (female 28.6% vs 18.2%), EF (58.4±10,6% vs 58.4±8.2%), and EuroSCORE II (3.4±1.1 vs 3.1±1.8). Results: All patients in group A underwent successful MVr with a median of three implanted chords while in group B 11 (50%) patients need a MV replacement (p=0.007). Six patients (43%) in group A did not need ICU stay (p=0.003). Transfusions were higher in Group B (7.1% vs 22.7%, p=0.007). Days of hospitalization were significantly lower in group A (4±1 vs 7.8±2.7). Long term follow-up is ongoing. Conclusions: In patients with recurrence of MR due to leaflet prolapse in previous standard MVr with annuloplasty, NeoChord shows promising results and may become the standard of care in this selected population.