Evidence map›Paper›PMID 40923060›Full record

ArticleJTCVS open2025

Posterior leaflet reconstruction in mitral valve repair: Does resect versus respect strategy matter?

Takuya Ogami, Ethan Chetkof, Johannes O Bonatti, Christopher Pantelis, Stephen D Waterford, Francis D Ferdinand, Irsa S Hasan, Derek Serna-Gallegos, David J Kaczorowski, Danny Chu and 2 more

Abstract read
In one paragraph

Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Takuya OgamiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Ethan ChetkofDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Johannes O BonattiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Christopher PantelisDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Stephen D WaterfordDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Francis D FerdinandDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Irsa S HasanDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Derek Serna-GallegosDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
David J KaczorowskiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Danny ChuDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Floyd W ThomaDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
Ibrahim SultanDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Previous randomized controlled trials demonstrated comparable outcomes between posterior leaflet resections and neochord implantation in mitral valve (MV) repair. However, these studies were limited up to 1-year follow-up, and more recent evidence suggested that leaflet resections may offer superior long-term outcomes. Methods: All patients who underwent MV repair with either resection or neochord implantation for posterior leaflet pathology between October 2011 and July 2024 were included. Propensity-score matching was used. Results: A total of 457 patients underwent posterior leaflet reconstruction, with 334 (73.1%) requiring leaflet resection (resection group) and 123 (26.9%) receiving neochordae (neochord group). The median [interquartile range] follow-up for survival and reintervention was 5.93 [2.00, 9.09] and 5.48 [1.84, 9.02] years, respectively. Overall, the mean age was 63.9 years, and the mean ejection fraction was 58.9%. Robotic-assisted surgery was performed in 28.9% (n = 132). The 30-day mortality was 2.4% (n = 11). Propensity-score matching provided 119 patients in each group. Kaplan-Meier curves demonstrated similar survival at 5 years between these groups (93.1 ± 2.8% in the resection group and 89.6 ± 3.1% in the neochord group, Conclusions: Neochordae were implanted in 27.3% of patients undergoing MV repair. Neochord implantation was associated with a greater risk of MV reintervention in the long term. Careful patient selection and technical considerations are important when choosing the repair method.

Indexed as

chord replacementdegenerative diseaseleaflet resectionmitral valve reinterventionmitral valve repairneochord implantationposterior leaflet prolapse

Identifiers

PMID40923060
PMCPMC12414421

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.