Related Experiment Video
Updated: Aug 21, 2025
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
1.7K
Cutting the second order chords during mitral valve repair
Antonio Maria Calafiore1, Sotirios Prapas2, Antonio Totaro1
1Department of Cardiovascular Diseases, Gemelli Molise, Campobasso, Italy.
Journal of Cardiac Surgery
|November 15, 2022
Summary
Second-order chordae tendinae play a crucial role in maintaining left ventricle geometry. Cutting these chordae may improve mitral valve repair outcomes by restoring leaflet curvature and coaptation.
Area of Science:
- Cardiovascular Anatomy
- Cardiac Biomechanics
- Surgical Innovation
Background:
- Chordae tendinae connect papillary muscles to the mitral valve, influencing valve function.
- First-order chordae secure leaflets; second-order chordae are implicated in left ventricle geometry.
- Papillary muscles act as shock absorbers, adapting to left ventricular wall changes.
Purpose of the Study:
- To investigate the functional significance of second-order chordae tendinae.
- To explore the impact of second-order chordae sectioning on mitral valve repair.
- To elucidate the role of chordal tethering in mitral regurgitation.
Main Methods:
- Analysis of chordae tendinae function and tension distribution.
- Review of experimental data on chordae tendinae rupture points.
- Evaluation of clinical reports and surgical outcomes related to mitral valve repair.
Main Results:
- Second-order chordae bear significantly higher tension than first-order chordae.
- Experimental data indicates first-order chordae have a high rupture threshold (6.8 N) compared to maximal physiological tension (0.4 N).
- Sectioning second-order chordae can restore anterior leaflet curvature and improve leaflet coaptation.
Conclusions:
- The functional importance of second-order chordae in mitral valve mechanics is increasingly recognized.
- Surgical strategies involving second-order chordae sectioning show promise for improving mitral repair outcomes.
- Chordal tethering significantly impacts anterior leaflet function in both primary and secondary mitral regurgitation, affecting long-term repair success.
More Related Videos
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
16
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
16
01:20Mitral Regurgitation I: Introduction
32
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
32
01:22Mitral Stenosis I: Introduction
26
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
26
01:25Mitral Regurgitation III: Medical Management
25
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
25
01:28Mitral Regurgitation IV: Nursing Management
69
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
69
01:27Mitral Stenosis IV: Nursing Management
27
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
27