Mitral valve repair with a device for artificial chordal implantation at 2 years

Alberto Weber; Maurizio Taramasso; Andrej Podkopajev; Vilius Janusauskas; Diana Zakarkaite; Rolf Vogel; Thierry Carrel

doi:10.1016/j.xjon.2021.08.041

Mitral valve repair with a device for artificial chordal implantation at 2 years

JTCVS Open. 2021 Oct 29:8:280-289. doi: 10.1016/j.xjon.2021.08.041. eCollection 2021 Dec.

Authors

Alberto Weber¹, Maurizio Taramasso¹, Andrej Podkopajev², Vilius Janusauskas², Diana Zakarkaite², Rolf Vogel³, Thierry Carrel⁴

Affiliations

¹ Heart Center, Hirslanden Clinic, Zurich, Switzerland.
² Vilnius University Clinic of Cardiac and Vascular Diseases, Vilnius, Lithuania.
³ Department of Cardiology, Bürgerspital Solothurn, Solothurn, Switzerland.
⁴ Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.

Abstract

Objectives: This study examines the early and midterm safety, efficacy, and durability of mitral valve repair for primary mitral regurgitation (MR) using the ChordArt device (CoreMedic) for chordal replacement.

Methods: Five patients with symptomatic severe primary degenerative MR due to isolated central posterior leaflet prolapse/flail were treated with the ChordArt device in a transseptal surgical approach and followed prospectively with periodical clinical and echocardiographic assessments for 2 years.

Results: Reduction of MR immediately after the implantation of artificial chords was achieved in all patients showing no or trace MR (<1+/4+). In all patients, MR <1+ was maintained during 24 months of follow-up. No dehiscence, detachment, or dislocation of the implanted ChordArt devices was observed. Transthoracic echocardiography showed that left ventricle end diastolic diameter significantly decreased during the whole follow-up period in comparison to baseline condition, especially at discharge and 1-month follow-up. Left ventricle end systolic diameter also significantly decreased during the whole follow-up period in comparison to baseline condition. Left atrial volume significantly decreased during the follow-up period in comparison to discharge. No major adverse events, as defined per protocol, were observed during the intervention or during the follow-up period.

Conclusions: The ChordArt device allows successful treatment of primary degenerative MR due to posterior mitral leaflet prolapse or flail, with a good safety profile and promising immediate clinical and echocardiographic benefits that are confirmed up to 24 months.

Keywords: EDD, end diastolic diameter; ESD, end systolic diameter; GLS, global longitudinal strain; LVEDD, left ventricular end diastolic diameter; LVEF, left ventricular ejection fraction; LVESD, left ventricular end systolic diameter; MAE, major adverse event; MR, mitral regurgitation; MV, mitral valve; NYHA, New York Heart Association; TEE, transesophageal echocardiograph; TTE, transthoracic echocardiograph; chordal repair; mitral regurgitation; mitral valve repair.