Five-year outcomes of chordal replacement therapy for primary mitral regurgitation: The CHAGALL (CHordArt System Study for the Treatment of Mitral ReGurgitAtion due to Leaflet ProLapse or fLail) study.
5 affiliations
- 1Heart Center Hirslanden, Zurich, Switzerland.
- 2Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
- 3CoreMedic, GmbH, Radolfzell, Germany.
- 4Department for Cardiology, Hospital Solothurn, Solothurn, Switzerland.
- 5Department of Cardiac Surgery, University Hospital, Basel, Switzerland.
Abstract
Objectives
The CHAGALL (CHordArt System Study for the Treatment of Mitral ReGurgitAtion due to Leaflet ProLapse or fLail) study is a prospective, first-in-human early feasibility study evaluating the technical feasibility, the long-term safety, and device durability of a novel chordal replacement system for the treatment of primary degenerative mitral regurgitation.Methods
Five patients with symptomatic severe primary degenerative mitral regurgitation attributable to isolated central posterior leaflet prolapse or flail underwent surgical implantation of the ChordArt chordal replacement system through a left atrial approach under cardiopulmonary bypass combined with ring annuloplasty. Clinical and transthoracic echocardiographic follow-up was prospectively performed at discharge and through 60 months.Results
Technical device success was achieved in all patients. Mitral regurgitation was reduced to none or trace immediately after implantation and remained stable throughout the 5-year follow-up. No device-related major adverse events, structural device failure, implant dislodgement, chordal rupture, reoperation, or rehospitalization occurred. Reverse cardiac remodeling was observed, including reduction in left ventricular end-diastolic diameter and left atrial volume, whereas left ventricular function remained preserved during long-term follow-up.Conclusions
Surgical implantation of the ChordArt chordal replacement system was simple to perform and demonstrated excellent long-term technical durability and sustained clinical performance over 5 years. These findings support further clinical evaluation of this technology and the ongoing development of a fully transcatheter transseptal delivery platform.
Related
- Clinical Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Pure Native Aortic Regurgitation: A Systematic Review and Meta-Analysis
- Outcomes of Surgical Versus Transcatheter Mitral Valve Repair or Replacement in Patients With Myocardial Infarction and Concomitant Mitral Regurgitation: A Retrospective Analysis of Real-World Data
- Myocardial Perfusion in Patients with Primary Mitral Regurgitation Due to Mitral Valve Prolapse
- Left Ventricular Remodelling and Functional Status Across Mitral Regurgitation Severity in Mitral Valve Prolapse
- Coexisting Moderate-to-Severe Tricuspid Regurgitation and Renal Dysfunction Identify a High-Risk Group After Transcatheter Aortic Valve Replacement
BibTeX
@article{weber2026fiveyear,
title = {{Five-year outcomes of chordal replacement therapy for primary mitral regurgitation: The CHAGALL (CHordArt System Study for the Treatment of Mitral ReGurgitAtion due to Leaflet ProLapse or fLail) study.}},
author = {Alberto Weber and Kestutis Rucinskas and Jodi Akin and Maurizio Taramasso and Michel Zuber and Rolf Vogel and Andrej Podkopajev and Vilius Janusauskas and Diana Zakarkaite and Thomas Bauer and Thierry Carrel},
journal = {JTCVS open},
year = {2026},
month = aug,
doi = {10.1016/j.xjon.2026.102055},
url = {https://europepmc.org/article/MED/42948106},
note = {CC BY},
}
RIS
TY - JOUR
TI - Five-year outcomes of chordal replacement therapy for primary mitral regurgitation: The CHAGALL (CHordArt System Study for the Treatment of Mitral ReGurgitAtion due to Leaflet ProLapse or fLail) study.
AU - Alberto Weber
AU - Kestutis Rucinskas
AU - Jodi Akin
AU - Maurizio Taramasso
AU - Michel Zuber
AU - Rolf Vogel
AU - Andrej Podkopajev
AU - Vilius Janusauskas
AU - Diana Zakarkaite
AU - Thomas Bauer
AU - Thierry Carrel
PY - 2026
DA - 2026/08/13
JO - JTCVS open
DO - 10.1016/j.xjon.2026.102055
UR - https://europepmc.org/article/MED/42948106
AB - Objectives The CHAGALL (CHordArt System Study for the Treatment of Mitral ReGurgitAtion due to Leaflet ProLapse or fLail) study is a prospective, first-in-human early feasibility study evaluating the technical feasibility, the long-term safety, and device durability of a novel chordal replacement system for the treatment of primary degenerative mitral regurgitation.Methods Five patients with symptomatic severe primary degenerative mitral regurgitation attributable to isolated central posterior leaflet prolapse or flail underwent surgical implantation of the ChordArt chordal replacement system through a left atrial approach under cardiopulmonary bypass combined with ring annuloplasty. Clinical and transthoracic echocardiographic follow-up was prospectively performed at discharge and through 60 months.Results Technical device success was achieved in all patients. Mitral regurgitation was reduced to none or trace immediately after implantation and remained stable throughout the 5-year follow-up. No device-related major adverse events, structural device failure, implant dislodgement, chordal rupture, reoperation, or rehospitalization occurred. Reverse cardiac remodeling was observed, including reduction in left ventricular end-diastolic diameter and left atrial volume, whereas left ventricular function remained preserved during long-term follow-up.Conclusions Surgical implantation of the ChordArt chordal replacement system was simple to perform and demonstrated excellent long-term technical durability and sustained clinical performance over 5 years. These findings support further clinical evaluation of this technology and the ongoing development of a fully transcatheter transseptal delivery platform.
SN - 2666-2736
ER -