Valvular & structural heart disease
Artificial chords in endoscopic mitral valve repair: a comparative analysis of surgical techniques and long-term outcomes
Authors' conclusion
Both single artificial chords and premeasured loops provided excellent perioperative and long-term outcomes in MIMVR. The loop technique facilitated shorter operative times and greater chordal implantation efficiency without compromising long-term repair durability or event-free survival.
Study context
- Population
- Patients who underwent minimally invasive mitral valve repair (MIMVR) at the University Hospital Innsbruck, Austria, 2001–2023consecutive patients who underwent MIMVR, 581 received artificial chords
- Participants
- 1,186 patients
- Comparison
- Single artificial chords versus premeasured loops
- Loop groupn = 430
- Single expanded polytetrafluoroethylene (ePTFE) chord groupn = 151reference
- Outcome
- Survival
- Follow-up
- 1, 5 and 10 years (median 5.0 (4.45-5.53) years)
Methodological detailscompeting risk analysis, reported according to the Mitral Valve Research Consortium criteria
- Competing risk analysis
- Reported according to the Mitral Valve Research Consortium criteria
Main finding
As reported in the abstract
Survival at 1 year
98.4%
Survival at 5 years
95.4%
Survival at 10 years
92.7%
Further findings
| Outcome | Loop group | Single ePTFE chord group | Hazard ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| Cumulative incidence of death or reoperation · 15 yearsCompeting risk analysis | 8.5% | 11.0% | 0.95 (0.44–2.06) | P = 0.90 | |
| 0.512Hazard ratio (log scale) |
Cross-clamp time · shorter with loop technique
P < 0.001
Independent predictors of long-term success
| HR (CI) | P value | ||
|---|---|---|---|
| Left atrial appendage occlusionOnly independent predictor | 0.11 (0.014–0.839) | P = 0.033 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | Loop group | Single ePTFE chord group | P value |
|---|---|---|---|
| Number of implanted chordsMore with loop technique | 5.0 | 2.0 | P < 0.001 |
| Event-free survival · 10 yearsNo significant difference | 92% (range 87–97%) | 93% (range 89–97%) | P = 0.5 |
Independent predictors of long-term success
- Choice of technique did not influence long-term outcomes
Original publication
Artificial chords in endoscopic mitral valve repair: a comparative analysis of surgical techniques and long-term outcomes. Heart. Published 20 April 2026. doi:10.
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