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Artificial chordae.

Tirone E David1

  • 1Division of Cardiovascular Surgery of Toronto General Hospital, 200 Elizabeth Street-13EN219, University of Toronto, Toronto, Ontario, Canada. tirone.david@uhn.on.ca

Seminars in Thoracic and Cardiovascular Surgery
|June 16, 2004
PubMed
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Expanded polytetrafluoroethylene (ePTFE) sutures effectively replace damaged chordae tendineae in mitral valve repair. This technique demonstrates excellent long-term freedom from mitral regurgitation and reoperation, proving safe and valuable for valve disease treatment.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science
  • Medical Devices

Background:

  • Expanded polytetrafluoroethylene (ePTFE) sutures have been utilized for chordae tendineae replacement since 1985.
  • These sutures are employed for correcting mitral and tricuspid valve leaflet prolapse and for papillary muscle resuspension during mitral valve replacement when native chordae are unsalvageable.

Purpose of the Study:

  • To evaluate the efficacy and safety of ePTFE sutures for artificial chordae tendineae creation in mitral valve repair.
  • To assess long-term outcomes including freedom from mitral regurgitation and reoperation.

Main Methods:

  • Utilized 5CV and 6CV Gore-Tex sutures to create artificial chordae tendineae for anterior, posterior leaflets, and commissural areas.
  • Modified techniques involved creating interdependent, self-adjusting artificial chordae from single sutures passed through papillary muscles and leaflets.

Related Experiment Videos

  • Retrospective analysis of 288 patients undergoing mitral valve repair for degenerative disease between 1985 and 1998.

    • Main Results:

    • At a mean follow-up of 4.8 years, 10-year freedom from mitral regurgitation >2+ was 88% ± 6%.
    • 10-year freedom from reoperation was 92% ± 2%.
    • Repair failures were not attributed to the artificial chordae.

    Conclusions:

    • Gore-Tex sutures are an excellent, safe material for replacing chordae tendineae.
    • This technique provides a valuable adjunct for treating mitral and tricuspid valve disease.