Transapical Off-Pump Mitral Valve Repair With NeoChord DS1000 Device

The transapical artificial chord implantation technique using the NeoChord DS1000™ (NeoChord, Inc., St. Louis Park, MN, USA) system allows re-establishment of normal leaflet motion under real-time two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography guidance. With this technique, chord implantation and adjustment of their length is achievable without the use of cardiopulmonary bypass and without sternotomy.

The NeoChord DS 1000™ system consists of a single-use device which allows the capture of the valve leaflet, as well as the deployment of artificial expanded polytetrafluoroethylene chords. It can be inserted and removed multiple times so that the surgeon can implant as many chords as desired. The jaw of the device has four fiber optic sensors, which allows for confirmation of an adequate tissue grasping using an external display.

Artificial chordae length is adjusted under 2D/3D echocardiographic guidance to obtain adequate mitral valve competence and, in the end, they are fixed on the left ventricular apex with a hard Teflon pledget.

Additional Resource

Colli A, Zucchetta F, Torregrossa G, et al. Transapical off-pump mitral valve repair with Neochord implantation (TOP-MINI): step-by-step guide. Ann Cardiothorac Surg. 2015;4:295-297.