How to do itPre-Measured Artificial Chordae for Mitral Valve Repair
Section snippets
Valve Inspection
After review of the intraoperative transesophageal echocardiogram and surgical exposure, systematic inspection of all valve components was performed. The prolapsing segment and elongated or ruptured chordae were identified. Stay sutures were placed around normal chords on either side of the prolapsing segment; the segment of leaflet between these sutures was the region that required chordal support. Next, the papillary muscles were inspected to identify the site for chordal attachment.
Comment
A variety of techniques are available to correct anterior leaflet prolapse. Although the creation of artificial chordae was described more than 2 decades ago, it has recently increased in popularity. The innovation by Von Oppell and Mohr [1] and the recent development of a commercially available caliper to facilitate the use of pre-measured chordae (Estech, San Ramon, CA) considerably simplifies the procedure. As with Von Oppell and Mohr [1], we find this technique to be both reliable and
References (4)
- et al.
Chordal replacement for both minimally invasive and conventional mitral valve surgery using premeasured Gore-Tex loops
Ann Thorac Surg
(2000) Artificial chordae
Sem Thorac Cardiovasc Surg
(2004)
Cited by (33)
Anatomical Mitral Valve Repair: Mathematical Prediction of Artificial Chordae Length in Para-Commissural Regions
2024, Current Problems in CardiologySimple versus complex degenerative mitral valve disease
2018, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Historically, repair of an anterior leaflet has been more challenging than posterior leaflet repair and has been accompanied by reduced durability.5,23-25 Anterior repair techniques have evolved from chordal shortening and chordal transfer to insertion of polytetrafluoroethylene chordae.5,26-28 Creation of artificial chordae has been associated with excellent durability and is amenable to less invasive approaches, making it our preferred technique in recent years.
Premeasured Chordal Loops for Mitral Valve Repair
2016, Annals of Thoracic SurgeryMitral valve repair with artificial chordae: A review of its history, technical details, long-term results, and pathology
2012, Annals of Thoracic SurgeryCitation Excerpt :Each two-armed Gore-Tex suture allows the creation of a pair of neochordae. Recently, techniques have been proposed by which multiple chordae can be obtained by using premeasured Gore-Tex loops [36–38]. In this technique, 4-0 to 6-0 sutures are usually used to construct as many chordae as considered necessary.
Is an anterior mitral leaflet prolapse still a challenge?
2010, Archives of Cardiovascular DiseasesAccessory left atrial chordae: An unusual cause of mitral valve insufficiency
2010, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :The abnormal chordae was resected flush with the atrial wall and the edge of the leaflet, and the central cleft was closed with simple sutures. The normal chordae were measured, and polytetrafluorethylene (Gore-Tex 4-loop neochordal structures; W. L. Gore & Associates, Inc, Newark, Del) 4-loop neochordal structures were attached between the free edge of the anterior leaflet and the base of the posteromedial papillary muscle using our previously described technique.1 The valvuloplasty was reinforced with a posterior ring annuloplasty using a 28-mm Cosgrove–Edwards band.