May the Force Be With You

Abstract

Surgical repair of primary mitral regurgitation (MR) can be durably achieved with very low operative risk using a multitude of resection and nonresection techniques. Surgeons in the United States use polytetrafluoroethylene (PTFE) neochords for nonresection repair of primary MR in nearly one quarter of all cases.1 In experienced hands, a complete PTFE neochordal repair strategy can achieve excellent long-term results.2 However, many surgeons often struggle with the same technical challenges: (1) where on the leaflet to insert the neochord; (2) where and how to anchor the neochord; and (3) how tight or how long to make it.