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Is chordal insertion the procedure of choice in mitral valve repair?

  • J. Seeburger
  • F.W. Mohr

Abstract

Degenerative mitral valve disease is frequently represented by elongated and/or ruptured chordae tendineae which leads to prolapse of the mitral valve (MV) and, thus, to mitral regurgitation (MR). In such cases, MV surgery provides a curative treatment. A simple surgical procedure to address MV prolapse is to replace the diseased chordae tendineae by polytetrafluoroethylene (PTFE) sutures. This idea of chordae replacement was introduced by Frater and colleagues. They followed the attempt of completely replacing diseased chordae with PTFE sutures, a material very similar to native chordae in terms of biomechanical characteristics. Until today, several different techniques for implantation of neochordae in MV repair have been described with a very high rate of success and good long-term durability. Despite these promising results, the question remains whether chordal insertion is the procedure of choice in mitral valve repair?

Keywords

Mitral Valve Mitral Valve Repair Mitral Valve Leaflet Posterior Mitral Leaflet Mitral Valve Insufficiency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Frater RW, Vetter HO, Zussa C, Dahm M (1990) Chordal replacement in mitral valve repair. Circulation 82:IV125–IV130PubMedGoogle Scholar
  2. David TE, Bos J, Rakowski H (1991) Mitral valve repair by replacement of chordae tendineae with polytetrafluoroethylene sutures. J Thorac Cardiovasc Surg 101:495–501PubMedGoogle Scholar
  3. David TE (2004) Artificial chordae. Sem Thorac Cardiovasc Surg 16:161–168CrossRefGoogle Scholar
  4. Seeburger J, Kuntze T, Mohr FW (2007) Gore-tex chordoplasty in degenerative mitral valve repair. Sem Thorac Cardiovasc Surg 19:111–115CrossRefGoogle Scholar
  5. Kuntze T, Borger MA, Falk V, Seeburger J, Girdauskas E, Doll N, Walther T, Mohr FW (2008) Early and mid-term results of mitral valve repair using premeasured Gore-tex loops (‘loop technique’). Eur J Cardiothorac Surg 33:566–572PubMedCrossRefGoogle Scholar
  6. Perier P, Hohenberger W, Lakew F, Batz G, Urbanski P, Zacher M, Diegeler A (2008) Toward a new paradigm for the reconstruction of posterior leaflet prolapse: midterm results of the »respect rather than resect« approach. Ann Thorac Surg 86:718–725PubMedCrossRefGoogle Scholar
  7. Rankin JS, Binford RS, Johnston TS, Matthews JT, Alfery DD, McRae AT, Brunsting LA 3rd (2008) A new mitral valve repair strategy for hypertrophic obstructive cardiomyopathy. J Heart Valve Dis 17:642–647PubMedGoogle Scholar
  8. Oppell UO, Mohr FW (2000) Chordal replacement for both minimally invasive and conventional mitral valve surgery using premeasured Gore-tex loops. Ann Thorac Surg 70:2166–2168CrossRefGoogle Scholar
  9. Seeburger J, Borger MA, Doll N, Walther T, Passage J, Falk V, Mohr FW (2009) Comparison of outcomes of minimally invasive mitral valve surgery for posterior, anterior, and bileaflet prolapse. Eur J Cardiothorac Surg 36(3):532–538PubMedCrossRefGoogle Scholar
  10. Seeburger J, Falk V, Borger MA, Passage J, Walther T, Doll N, Mohr FW (2009) Chordae replacement versus resection for repair of isolated posterior mitral leaflet prolapse: a egalité. Ann Thorac Surg 87:1715–1720PubMedCrossRefGoogle Scholar
  11. Carpentier A (1983) Cardiac valve surgery – the »French correction«. J Thorac Cardiovasc Surg 86:323–337PubMedGoogle Scholar
  12. Falk V, Seeburger J, Czesla M, Borger MA, Willige J, Kuntze T, Doll N, Borger F, Perrier P, Mohr FW (2008) How does the use of polytetrafluoroethylene neochordae for posterior mitral valve prolapse (loop technique) compare with leaflet resection? A prospective randomized trial. J Thorac Cardiovasc Surg 136:1205; discussion 1205–1206CrossRefGoogle Scholar
  13. Braunberger E, Deloche A, Berrei A, Abdallah F, Celestin JA, Meimoun P, Chatellier G, Chauvaud S, Fabiani JN, Carpentier A (2001) Very long-term results (more than 20 years) of valve repair with Carpentier’s techniques in nonrheumatic mitral valve insufficiency. Circulation 104:I8–I11PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • J. Seeburger
    • 1
  • F.W. Mohr
    • 1
  1. 1.Leipzig Heart CenterLeipzig UniversityLeipzigGermany

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