Neochordae Technique in Mitral Valve Repair
Neochordae Technique in Mitral Valve Repair
Mitral valve (MV) repair has turned into a preferable option for surgeons over the MV
 replacement. Since the 1960s, Surgeons use this technique for more efficiency and durability.
 On the other hand, the proper determination of length and placement of artificial neochordae
 is still a challenge beyond this technique. These challenges are still a vital area for
 research and debate between surgeons and researchers.

 In our novel technique,Investigators are not depending either on the preoperative
 investigations or intraoperative reference chordae in the adjustment of the optimal length of
 the neochordae, however, Researchers depend on the personal adjustment of the chordal length
 to the prolapsed scallop.
Mitral regurgitation (prolapse) and mitral stenosis are examples of diseases that affect the
 mitral valve. In mitral regurgitation, the leaflets do not close tightly and sway up and down
 allowing the blood to flow backward from the left ventricle into the left atrium. on the
 other hand, the mitral stenosis is caused by folding of thick leaflets of the valve which
 fuses together leading to low blood flow from the left atrium into the left ventricle and
 these cases are excluded from our trial. In mitral regurgitation, Surgeons prefer the mitral
 valve repair over the mitral valve replacement, But still, there are a lot of challenges
 towards this technique.

 For decades, Surgeons used a lot of techniques to determine the length of neochordae includes
 that:

 Determination of neochordal length by transoesophageal echocardiography or by using a
 landmark as a direct measurement. Previously, the surgeon applying the fixed loop length
 technique by using a custom-made caliper, and on the distance between the edge of a
 non-prolapsing segment and the tip of the papillary muscle (usually P1) to define the correct
 loop length. There are different types of papillary muscle and chordae as regards the shape,
 morphology, and length. So this reference distance is not fixed.

 Adjusting neochordal length according to valve function. Length is chosen when the
 regurgitation is completely removed. Existing of a large number of neochordae will make this
 process more complex for the surgeon to decide.

 Mitral valve (MV) repair has turned into a preferable option for surgeons over the MV
 replacement. Since the 1960s, Surgeons use this technique for more efficiency and durability.
 On the other hand, the proper determination of length and placement of artificial neochordae
 is still a challenge beyond this technique. These challenges are still a vital area for
 research and debate between surgeons and researchers.

 In our novel technique, Investigators are not depending either on the preoperative
 investigations or intraoperative reference chordae in the adjustment of the optimal length of
 the neochordae, however, Researchers depend on the personal adjustment of the chordal length
 to the prolapsed scallop.
Inclusion Criteria:

 -  Prolapsed or ruptured chordae

 -  Either degenerative or ischemic

 Exclusion Criteria:

 -  Patient with redo Mitral Valve surgery

 -  Patient with severe rheumatic mitral stenosis (MS).