Objective : Chordal replacement with PTFE is increasingly used in mitral valve repair. For ensuring appropriate length, we have previously proposed the anterior annulus as a reference level. The aim of this study is to review our 7 years experience and to assess long term stability of PTFE chardae.
Patient and method : Between 1996 and 2002, 103 pts underwent chord replacement with PTFE for anterior leaflet prolapse repair (isolated 80, associated to posterior prolaps 15pts). Eight pts had a commussural prolapse. Eighty pts had degenerative disease, 31 had rhumatic disease and 6 suffured acute endocarditis. All patients had perioperative TEE.
In addition to chordal replacement with PTFE several operative techniques were performed depending on the type and extension of the underlying disease . Chordal replacement was carried out before other lesions repair and annuloplasty. Mean number of artificial chordae was 5 (2-12).
Results : Ensuring of the appropriate length and repair of the prolapse was achieved in all patients.
Only 4 patients experienced over correction and requiered perioperativee correction early in our experience. Hospital mortality was 1.8 % . Discharge TTE showed stability of the repair. Mean follow-up is 39 months (12-94). There were two cardiac unrelated deaths. Freedom from stroke, endocarditis, reoperation, and severe MR is 100%.
Conclusion : Use of the anterior mitral annulus as a reference level for ensuring the exact length is simple, accurate and provides excellent long term results.