**4. Results**

Demographic and clinical data was obtained from the hospital records. Mean age was 63 ± 7.7, 15 were male. All patients were in NYHA class III.2 patients required tricuspid valve repair and 4 patients needed coronary bypass surgery. Interpapillary distance in patients with inferior wall involvement was 31 ± 3 mm. One patient required LA myxoma removal. Median surgical risk based on Logistic Euroscore was 3.95% (2.38%). Median Total cross clamp time was 74 ± 7 min. Total extracorporeal time being a median of 120 (80 to 146) minutes. 4 neochordae were created in 10, 6 in 12, 2 in 3 patients. 28 sized annuloplasty ring was used in one patient, 30 in 12 patients, 32 in 11 patients and 34 in 1patient. Mean coaptation height achieved was 8 ± 3 mm. 25 patients had zero MR on post bypass TEE. No patients had SAM. Preoperative annular area was 19.2 ± 4 cm<sup>2</sup> and post op being 7.7 ± 2 cm<sup>2</sup> by 3D methods showing a reduction efficiency of 60%. The median ICU stay was 2 days (1–10) days and median total hospital stay was 7 days (5–17) days. One patient had atrial fibrillation which reverted with pharmacological therapy, 1 case of acute renal failure in a patient with chronic renal failure and type 1 neurological dysfunction in one patient. Preop ROA was median 9.10 (6.1–26.4) to post op of 1.10 (0.3–2.1) cm<sup>2</sup> P = 0.001. At follow up of 90 days the median ROA was –0.50 (0.9 cm<sup>2</sup> ) P = 0.001. LVEF was median of 63% (30–77) before surgery to 68% (55–80) post op P = 0.14. Clinical follow-up was 100%. 25 patients are alive, and all were free of MR signs and symptoms. No patient required reoperation for recurrent MR. Echocardiographic follow-up has been obtained at the discretion of the referring cardiologists. Echocardiograms have been obtained on all patients with a mean follow-up of 1 year. All cause mortality at 30 days, 60 days, 90 days; 1 year after surgery has been zero. No reoperations were needed due to recurrent mitral regurgitation, no new onset atrial fibrillation or embolism or endocarditis was noted. No death, reoperations, heart failure, endocarditis, thromboembolism or pacemaker implantations were needed in any of these patients on follow up until Dec 25th 2017 (median of 9 months). Follow-up was performed till Dec 25 2017 was 100% complete for survival. All patients are currently in NYHA class I.
