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Ann Thorac Surg 2003;76:2169-2170
© 2003 The Society of Thoracic Surgeons

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Correspondence

Revisiting Dr Carlos Duran’s work: Reply

Department of Cardiothoracic Surgery, Knightsbridge Wing, St. George's Hospital, Blackshaw Rd, London SW17 OQT, United Kingdom, UK,

e-mail: mazin.sarsam{at}stgeorges.nhs.uk

To the Editor:

I appreciate the interest shown by Dr Maxwell and colleagues in my article [1]. We are all aware of the enormous contribution of Professor Duran to the field of mitral valve repair. The purpose of the article, which was focused solely on the technique of inserting artificial chordae and determining their length, was to assist practicing surgeons in this field. The technique is similar but not identical to the one described by Duran [2] in that the anchoring of the suture to the papillary muscle is different, as is anchoring the suture to the edge of the anterior leaflet. However, the principle for measuring the length of the chordae is the same.

Since publication, the technique has been modified in that my associates and I no longer use a single suture but two simple sutures to approximate the anterior and posterior mitral valve leaflets, one on each side of the double-armed Gore-Tex suture. This prevents the Gore-Tex suture from sliding and produces a more accurate length.

Soon after my article was published, I received an e-mail from Dr Robert Frater, who pioneered the technique of polytetra+fluoroethylene artificial chordae. He brought to my attention the first time the principle by which chordal length is determined was reported [3], and I later found a reference to the same principle in a discussion on deciding how to shorten an elongated chorda by Dr Frater [4].

References

1. Sarsam M.A.I. Simplified technique for determining the length of artificial chordae in mitral valve repair. Ann Thorac Surg 2002;73:1659-1660.[Abstract/Free Full Text]
2. Duran C.M.G. Surgical techniques for the repair of anterior mitral leaflet prolapse. J Card Surg 1999;14:471-481.[Medline]
3. Frater R.W.M. Anatomical rules for the plastic repair of a diseased mitral valve. Thorax 1964;19:458-464.[Free Full Text]
4. Frater RWM. Discussion. In: Proceedings from Le Club "Mitrale" Hospital Broussais. Paris, France: March 1996: 355

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mazin A. I. Sarsam Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sarsam, M. A. I. Search for Related Content PubMed PubMed Citation Articles by Sarsam, M. A. I. Related Collections Valve disease