Preoperative determination of artificial chordae length

We present a practical and accurate way to measure artificial chordae length in mitral valve repair. During preoperative transesophageal echocardiography, the distance between the head of the posterior papillary muscle and the mitral annulus plane at the coaptation of the leaflets is measured; this is the length of the new chorda. Every millimeter of braided 4-0 Gore-Tex (W.L. Gore & Assoc, Flagstaff, AZ) contains two tight reverse knots; therefore, the number of the knots determines the accurate length of the artificial chorda.