Mitral valve repair with artificial chords: Tips and tricks

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Biomaterials in Medicine

Background:

• Mitral valve regurgitation (MR) affects up to 10% of the population, necessitating reconstructive strategies.
• Traditional repair involves tissue resection; however, chordal replacement has evolved significantly.
• Expanded polytetrafluoroethylene (ePTFE) sutures and transcatheter approaches like NeoChord and Harpoon TSD-5 represent advancements in artificial chord use.

Purpose of the Study:

• To describe the current application of artificial chords in surgical mitral valve repair.
• To summarize techniques, challenges, and innovative solutions for artificial chord implantation.
• To provide insights into real-world surgical practices for mitral valve reconstruction.

Main Methods:

• Review of current surgical techniques for artificial chord implantation in mitral valve repair.
• Analysis of different suturing methods (single, running, loop) for chord attachment.
• Discussion of strategies to determine and achieve adequate chordal length during surgery.

Main Results:

• Artificial chords are increasingly utilized in mitral valve repair, with various implantation techniques available.
• Challenges include accurate papillary muscle exposure and establishing optimal chordal length for dynamic function.
• Creative surgical solutions have been developed to address the complexities of artificial chord implantation.

Conclusions:

• Artificial chord implantation is a viable strategy for mitral valve repair, offering alternatives to traditional methods.
• Mastery of implantation techniques and addressing chordal length determination are crucial for successful outcomes.
• Continued innovation in artificial chord technology and surgical approaches is advancing mitral valve reconstructive surgery.