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Surgical technique for artificial mitral chordae implantation
Journal of Cardiac Surgery
|December 1, 1991
Summary
Expanded-polytetrafluoroethylene (ePTFE) mitral chordae offer a viable solution for mitral valve repair when traditional methods fail due to subvalvular apparatus damage. This technique successfully restored function in most patients, improving their quality of life.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Medical Engineering
Background:
- Mitral valve repair failure often results from diffuse subvalvular apparatus damage, limiting standard surgical techniques.
- Established methods like chordal transposition or shortening are frequently unsuitable for these complex cases.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of using expanded-polytetrafluoroethylene (ePTFE) mitral chordae for valve reconstruction.
- To present the surgical procedure and outcomes for patients undergoing mitral valve repair with ePTFE chordae.
Main Methods:
- Clinical application of ePTFE mitral chordae initiated in 1986 following extensive animal experimentation.
- Surgical procedure details are provided for 51 patients with a mean follow-up of 20 months (range 3-57 months).
Main Results:
- Forty-one patients (80%) improved to New York Heart Association Functional Class I, and three (6%) to Class II.
- Four patients required valve replacement during the initial operation; one later died of cardiac failure, and two needed reoperation.
Conclusions:
- ePTFE mitral chordae provide a valuable alternative for mitral valve repair, particularly in degenerative cases with subvalvular apparatus abnormalities.
- This technique, used adjunctively with traditional procedures, can expand the number of successful mitral valve repairs.