Our Summary

The study examines a type of heart surgery, specifically a neochord implantation (NC), performed without stopping the heart, on patients suffering from a condition where the mitral valve in their heart doesn’t close properly. This condition can lead to severe symptoms. The patients were divided into two groups based on the severity of their condition: those with favorable anatomy (FA) and those with unfavorable anatomy (UA).

From November 2013 to March 2016, 100 patients underwent this procedure. The study’s findings were evaluated on the basis of established guidelines. The success rate for the procedure was high, with 98% technical success and 94% overall success. The 30-day mortality rate was low at 2%.

The device implanted was successful in 94% of cases after 30 days, 92% after 1 year, and 78% after 5 years. Overall, patient success was high at 92% after 1 year. The average follow-up period was just over 5 years.

At the 5-year mark, 83% of patients were still alive, with no significant difference between the FA and UA groups. However, the recurrence of severe mitral regurgitation (the condition the procedure aims to treat) was 14% in FA patients and 63% in UA patients. Also, the FA group had a lower rate of needing another intervention (14.7% vs 43.4% in the UA group).

In conclusion, this type of heart surgery could be a good option for patients with this type of heart valve disease, particularly if their anatomical conditions are favorable.

FAQs

  1. What is a neochord implantation and what condition does it aim to treat?
  2. What was the success rate of the neochord implantation procedure according to the study?
  3. Was there any significant difference between the patients with favorable anatomy and those with unfavorable anatomy in the success rate of the implantation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about mitral valve repair is to maintain regular follow-up appointments with your healthcare provider to monitor the success of the procedure and address any potential complications or issues that may arise. Additionally, it is important to follow a healthy lifestyle, including regular exercise, a balanced diet, and avoiding smoking, to support the long-term success of the surgery and overall heart health.

Suitable For

Patients who are typically recommended mitral valve repair are those suffering from a condition where the mitral valve in their heart doesn’t close properly, leading to severe symptoms. In this study, patients with both favorable anatomy and unfavorable anatomy were included, with the procedure showing high success rates in both groups. Patients with favorable anatomy had better outcomes in terms of recurrence of severe mitral regurgitation and the need for another intervention. Overall, this type of heart surgery appears to be a good option for patients with this condition, especially those with favorable anatomical conditions.

Timeline

Before the mitral valve repair procedure, patients may have experienced symptoms such as shortness of breath, fatigue, chest pain, and palpitations due to the improper closure of the mitral valve. They would have undergone diagnostic tests such as echocardiograms and possibly cardiac catheterization to assess the severity of their condition.

After the mitral valve repair procedure, patients typically experience an improvement in their symptoms and overall quality of life. They may still need to take medications to manage their heart health, but the surgery can significantly reduce the risk of complications associated with mitral valve disease. Regular follow-up appointments with their healthcare provider are essential to monitor their progress and ensure the long-term success of the procedure.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mitral valve repair include:

  1. What are the potential risks and complications associated with the neochord implantation procedure?
  2. How does this procedure compare to traditional open-heart surgery for mitral valve repair?
  3. What is the success rate of the procedure in patients with my specific condition and anatomy?
  4. How long is the recovery process expected to be after the procedure?
  5. Will I need to take medication or make lifestyle changes after the surgery?
  6. What is the long-term outlook for patients who undergo this procedure?
  7. Are there any alternative treatment options available for my condition?
  8. How often will I need follow-up appointments and monitoring after the surgery?
  9. What symptoms should I watch out for that may indicate a complication or recurrence of mitral regurgitation?
  10. Are there any specific restrictions or limitations I should be aware of after the surgery?

Reference

Authors: D’Onofrio A, Fiocco A, Nadali M, Mastro F, Aruta P, Lorenzoni G, Pittarello D, Gerosa G; Padova Neochord Working Group. Journal: J Thorac Cardiovasc Surg. 2023 Mar;165(3):1036-1046.e4. doi: 10.1016/j.jtcvs.2022.02.059. Epub 2022 Apr 9. PMID: 35624055