{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:34:21Z","timestamp":1763454861918,"version":"3.45.0"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T00:00:00Z","timestamp":1562889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Intraoperative assessment of the repaired mitral valve (MV) by saline testing is a standard maneuver in MV repair. Despite a growing interest in application of nonresectional techniques, the utility of the saline test following repair with neochordae has not been systematically assessed. We sought to determine the accuracy of the saline test following MV repair using nonresectional techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We included 25 adult patients undergoing MV repair for degenerative valve disease between November 2018 and February 2019. The surgical repair was performed using nonresectional techniques with neochordae either through a sternotomy or a robotic approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010five patients underwent successful MV repair, all with excellent echocardiographic results. In four patients (16%), the saline test suggested discrete areas of leaflet malcoaptation and leakage, leading to additional repair maneuvers. In 16 patients (64%), the final saline test demonstrated excellent coaptation with little or no leak. In nine patients (36%), the final saline test was inconclusive (ventricle could not be filled) or poor (diffuse leak). Post\u2010repair intraoperative echocardiography demonstrated no or trivial mitral regurgitation in all patients, and no patient required a second pump run.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After repair with neochordae, a satisfactory saline test indicates a good repair and discrete leaks on the saline test suggest the need for further surgical maneuvers. If the surgeon has employed standard repair techniques using neochordae but the saline test is inconclusive or poor, additional repair maneuvers are generally unnecessary, as intraoperative echocardiography will usually demonstrate a good repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocs.14167","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T11:03:36Z","timestamp":1562929416000},"page":"965-968","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intraoperative assessment of mitral valve repair: Validation of the saline test with nonresectional repair techniques"],"prefix":"10.1155","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0451-5381","authenticated-orcid":false,"given":"Raphaelle A.","family":"Chemtob","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per","family":"Wierup","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie L.","family":"Mick","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-7543","authenticated-orcid":false,"given":"A. Marc","family":"Gillinov","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Cleveland Clinic  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,12]]},"reference":[{"key":"e_1_2_7_1_2_1","first-page":"230","article-title":"Mitral valve repair versus replacement","volume":"4","author":"Mick S","year":"2015","journal-title":"Ann Cardiothorac Surg"},{"key":"e_1_2_7_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.03.091"},{"key":"e_1_2_7_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(93)90396-Y"},{"key":"e_1_2_7_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.08.008"},{"key":"e_1_2_7_1_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc37t1.094903"},{"key":"e_1_2_7_1_7_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S0022-5223(19)39144-5","article-title":"Cardiac valve surgery\u2010\u2010the \u201cFrench correction.\u201d","volume":"86","author":"Carpentier AF","year":"1983","journal-title":"J Thorac Cardiovasc Surg"},{"key":"e_1_2_7_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.05.015"},{"key":"e_1_2_7_1_9_1","first-page":"273","article-title":"Prolapse of the posterior leaflet: resect or respect","volume":"4","author":"Perier P","year":"2015","journal-title":"Ann Cardiothorac Surg"},{"key":"e_1_2_7_1_10_1","first-page":"809","article-title":"Chordae replacement versus leaflet resection in minimally invasive mitral valve repair","volume":"2","author":"Holubec T","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"e_1_2_7_1_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-014-0465-z"},{"key":"e_1_2_7_1_12_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2007.158808"},{"key":"e_1_2_7_1_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-014-1062-6"},{"key":"e_1_2_7_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.04.052"},{"key":"e_1_2_7_1_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy317"}],"container-title":["Journal of Cardiac Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocs.14167","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocs.14167","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocs.14167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:29:41Z","timestamp":1763454581000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocs.14167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,12]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1111\/jocs.14167"],"URL":"https:\/\/doi.org\/10.1111\/jocs.14167","archive":["Portico"],"relation":{},"ISSN":["0886-0440"],"issn-type":[{"type":"print","value":"0886-0440"}],"subject":[],"published":{"date-parts":[[2019,7,12]]},"assertion":[{"value":"2019-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}