• Pittarello Demetrio, Colli Andrea, Falasco Gianclaudio, Marcassa Antonio, Gerosa Gino, and Ori Carlo.
• Department of Medicine, Anesthesia and Intensive Care Unit, University of Padova, Padova, Italy.
• Ann Card Anaesth. 2015 Apr 1; 18 (2): 191-7.

BackgroundTransapical off-pump mitral valve intervention with neochord implantation for degenerative mitral valve disease have been recently introduced in the surgical practice. The procedure is performed under 2D-3D transesophageal echocardiography guidance.MethodsThe use of 3D real-time transesophageal echocardiography provides more accurate information than 2D echocardiography only in all the steps of the procedure. In particular 3D echocardiography is mandatory for preoperative assessment of the morphology of the valve, for correct positioning of the neochord on the diseased segment , for the final tensioning of the chordae and for the final evaluation of the surgical result.Result And ConclusionThis article is to outline the technical aspects of the transesophageal echocardiography guidance of the NeoChord procedure showing that the procedure can be performed only with a close and continuous interaction between the anesthesiologist and the cardiac surgeon.

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