First in Man: Off-Pump Transapical Transcatheter Aortic Valve Implantation and Mitral Valve Repair.

We report the case of an 89-year-old man with severe aortic valve stenosis and concomitant severe mitral valve regurgitation. Due to his age and comorbidities, the patient was not accepted for open heart surgery. After interdisciplinary discussion with the heart team, the patient underwent a minimally invasive off-pump procedure combining aortic valve replacement with mitral valve repair. Cardiac surgeons performed a transapical aortic valve replacement, followed by mitral valve repair applying the NeoChord device (NeoChord Inc, St. Louis Park, MN) under three-dimensional transesophageal echocardiographic guidance by an interventional cardiologist. The patient's further clinical course was uneventful, and he did well on follow-up examinations.