Related Experiment Video
Updated: Jul 10, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Chordal cutting technique through aortotomy to treat chronic ischemic mitral regurgitation: surgical technique
Georges Fayad1, Thomas Modine, Richard Azzaoui
1Pôle de Chirurgie Cardiovasculaire, CHRU de Lille, France. g-fayad@chru-lille.fr
Objective:
To describe original surgical treatment in patients with ischemic mitral valve regurgitation due to tenting phenomenon.
Background:
The optimal surgical treatment of ischemic mitral regurgitation (MR) in patients with coronary artery disease is controversial. The standard treatment is revascularization and reduction annuloplasty. We describe the first clinical application of an original technique to treat MR, through aortotomy. The chordal cutting technique was described first in experimental studies by Messas et al.
Methods:
The procedure consisted in cutting the 2 strut chordae of the anterior mitral valve through a small aortotomy, using a brief conventional cardiopulmonary bypass. All the cases were controlled at the end of the procedure by transesophageal echocardiography (TEE).
Results:
Five patients were treated using this technique; the procedure was brief, effective and safe in all the patients. TEE showed no mitral regurgitation. No preoperative morbidity or mortality occurred and post-operative course was uneventful.
Conclusion:
Chordal cutting technique through aortotomy is a safe and effective technique that should be considered to treat severe ischemic mitral regurgitation due to tenting phenomenon.
Related Concept Videos
Mitral Regurgitation III: Medical Management
Mitral Stenosis III: Medical Management
Aortic Regurgitation III: Medical Management
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Stenosis I: Introduction
Mitral Regurgitation IV: Nursing Management

