Repair of mitral valve (MV) leaflet prolapse using chordal replacement is an established procedure in open heart surgery for the treatment of mitral regurgitation (MR). The technique has proven high reproducibility and excellent long-term outcomes for posterior leaflet prolaspe, with freedom from valve-related reoperation of >95%.1, 2 Striving toward a less-invasive treatment for structural heart disease, the concept of transapical beating heart chordae replacement for MV repair using the NeoChord DS1000 device (NeoChord Inc; Minnetonka, Minn) has been introduced and proven in acute and chronic animal studies.3 The rationale of this approach is to imitate native valve anatomy by replacing ruptured or elongated chordae tendineae of the MV that cause prolapse of the MV leaflet with subsequent MR. The aim of this report is to elucidate this new therapy while presenting our initial experience with this procedure in humans. ### Patient Screening The primary selection criteria, including morphological characteristics of …