Artificial Chordae for Mitral Valve Repair: Mid-Term Clinical and Echocardiographic Results

Abstract

Background: This paper reports on the mid-term clinical and echocardiographic results of mitral valve repair with chordal replacement. Methods: Sixty-nine patients (mean age 61 ± 14 years) underwent mitral valve repair with chordal replacement. The etiology was degenerative in 53 (77 %), rheumatic in 7 (10 %), ischemic in 6 (9 %) and infective in 3 (4 %). Mean ejection fraction was 58 ± 14. In 35 patients (51 %), a minimally invasive approach was used. Mean follow-up time was 45 ± 27 months. Results: Anterior leaflet chordae were replaced in 58 (84 %) patients. There were 3 operative deaths. Freedom from non-trivial recurrent mitral regurgitation (MR) was 81.3 ± 8.7 % at 97 months. Follow-up echocardiographic controls showed mild recurrent MR in 5 (8 %) patients and moderate in 2 (3.2 %). These two patients required reoperation due to mitral annulus redilation after suture annuloplasty. Competent neochordae were found at reoperation. Freedom from reoperation at 97 months was 96.6 ± 2.4 %. Four patients died during follow-up resulting in an actuarial survival of 87 ± 6.2 %. Conclusion: The replacement of chordae tendineae with ePTFE sutures during mitral valve repair has shown good mid-term results. The implantation of the neochordae can be also performed safely using minimally invasive procedures.

Key words

heart valve surgery - cardiovascular surgery - heart disease - mitral valve repair - chordae tendineae - expanded polytetrafluoroethylene

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