Calcification of Gore-Tex Neochord After Mitral Repair: Electron Microscopy

A 76-year-old woman presented with severe mitral valve regurgitation 6 years after mitral valve repair with Gore-Tex (expanded polytetrafluoroethylene, W.L. Gore & Associates Inc) neochords and ring annuloplasty. Echocardiography revealed a ruptured neochord. During successful mitral valve replacement, the explanted Gore-Tex neochords were found to be stiff and calcified, with a fracture. Electron microscopy was used to examine the explant and a control neochord. There was disruption of the microstructure with extensive calcium infiltration at the fracture point. Although this is a rare cause of late repair failure, it warrants yearly follow-up with echocardiography.