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The Annals of Thoracic Surgery, Vol 50, 367-373, Copyright © 1990 by The Society of Thoracic Surgeons
C Zussa, RW Frater, E Polesel, M Galloni and C Valfre
Failure of mitral valve reconstructive procedures often may be ascribed to
severe or progressive alterations of subvalvar apparatus. Expanded
polytetrafluoroethylene sutures were used to replace anterior leaflet
mitral valve chordae in 8 animals (hypertensive dogs and growing sheep).
After the positive results obtained during a 13-month follow- up, 5-0
sutures of the same material were introduced in clinical practice to
replace mitral valve chordae. Twelve patients had two to six anterior
leaflet chordae replaced for degenerative or rheumatic disease. In 3
patients, the intraoperative result was not acceptable and a prosthetic
valve was inserted during the same operation. One case of late failure has
been recorded so far (18 months after the procedure), owing to rupture of a
natural chorda shortened at operation. Since that event, we have implanted
supportive artificial chordae in case of diffuse alteration of natural
chordae. The remaining patients show satisfactory hemodynamic results, and
no valve-related events have been recognized up to 30 months after
operation. We suggest use of 5-0 polytetrafluoroethylene sutures in
replacing anterior leaflet chordae in degenerative, rheumatic, and
congenital mitral valve diseases.
ARTICLES
Artificial mitral valve chordae: experimental and clinical experience
Division of Cardiac Surgery, Regional Hospital, Treviso, Italy.
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