Objectives: Expanded polytetrafluoroethylene (ePTFE) sutures have been used for replacement of
ruptured or elongated chordae tendineae of the mitral valve since 1996 in our unit.
This paper reports of the mid-term clinical and echocardiographic results of mitral
valve repair with chordal replacement.
Material and Methods: Sixty–seven patients (mean age 60±13 years) underwent mitral valve repair with chordal
replacement. Etiology was degenerative in 50, rheumatic in 9, infective in 2 and ischemic
in 6. Mean ejection fraction was 58±15 and 88% were in New York Heart Association
(NYHA) class III-IV. Eight patients had previous heart operation, and 22 were in atrial
fibrillation. In 32 patients, a minimally invasive approach was used. All patients
were followed for a mean of 36±21 months. Echocardiographics controls were conducted
at one and five years postoperatively.
Results: Anterior leaflet chordae were replaced in 50 patients. There were 3 operative deaths.
The echocardiographic controls showed moderate residual mitral regurgitation in 4
and mild in 4 patients. The mean postoperative NYHA class was reduced to 0.2±0.5.
Actuarial survival at 5 years was 92.3±3.8%. Two patients required reoperation due
to mitral annulus redilatation after suture annuloplasty in the follow-up. Both had
competent neochordae found at reoperation. Freedom from reoperation at 5 years was
96.3±2.6% and freedom from nontrivial mitral regurgitation was 84.7±5.4%.
Conclusions: Replacement of chordae tendineae with ePTFE sutures during mitral valve repair has
shown good mid-term results. The implantation of the neochordae can be performed safely
in minimally invasive procedures
