Short- and long-term results of chordal reconstruction using artificial suture material (polytetrafluoroethylene and polypropylene) in the dog

Abstract

No previous reports have compared the suitability of expanded polytetrafluoroethylene (ePTFE) and polypropylene as artificial suture materials for chordal reconstruction in mitral valve plasty (MVP) in the dog. Twelve normal dogs were subjected to MVP using surfaceinduced deep hypothermia. In the short-term group (1.5-4 months after surgery), all ePTFE sutures were covered by a tissue sheath including the paired suture arms, which gave the appearance of native chordae from 2 months after surgery. In contrast, all polypropylene sutures were not covered by tissue, and appeared the same as the paired polypropylene suture arms at the operation. In the long-term group (12 months after surgery), all ePTFE sutures were covered by a tissue sheath, which appeared the same as that in the short-term group, and had flexibility without increased thickness with time. In contrast, although the polypropylene suture was covered completely by a tissue sheath in 1 dog, all the other polypropylene sutures were exposed except for both ends of the suture. ePTFE may be superior to polypropylene as an artificial suture material for chordal reconstruction in MVP.

Prolonged survival with mitral valve plasty for acute mitral regurgitation due to mitral valve dysplasia and chordal rupture in a young small dog: A case report

“…There are three main methods of MVP: (1) AP for a dilated mitral annulus, (2) valvuloplasty for a deformed valve leaflet, and (3) chordal repair for ruptured or elongated chordae ( Carpentier, 1983 ). Recently, a novel artificial chordal replacement (ACR) technique using a PTFE suture for ruptured or elongated chordae was developed in sheep ( Vetter et al ., 1986 ), humans ( David et al ., 1991 ), and dogs ( Kanemoto et al ., 2017a , b ). MVP is usually a combination of two or three of the methods according to the mitral valve lesions.…”

“…In the present case, the MVP consisted of a novel ACR using a PTFE suture for ruptured chordae in the anterior leaflet and the Kay method on the posterior commissure for the AP in a small dog. There are two reports that focused on long-term survival in small dogs ( Mizuno et al ., 2013 ; Kanemoto et al ., 2017a , b ). The patients in the report by Kanemoto et al survived for 9 years and 1 month and 7 years and 10 months after surgery, respectively; both patients died of old age.…”

Open-heart techniques and mitral valve plasty for mitral regurgitation in toy- and small-breed dogs: A review

“…Recently, a new ACR using a PTFE suture was developed in sheep ( Frater et al ., 1983 ; Vetter et al ., 1986 ; Revuelta et al ., 1989 ; Zussa et al ., 1990 ) and applied to human MVP ( David et al ., 1991 , 1993 ). In 1995, we studied the PTFE suture as an artificial chordae in experimental dogs ( Kanemoto et al ., 1995 , 2017a ). Since then, we have used PTFE suture for ACR in all clinical MVPs performed in small dogs ( Kanemoto et al ., 1999 , 2001 , 2004 , 2010 ) ( Fig.…”

“…5A ). The PTFE sutures are already covered by endocardium in 2 months, although Proline sutures are almost not covered even after 1 year ( Kanemoto et al ., 2017a ). Moreover, PTFE sutures used for chordal reconstruction were covered with endocardium after 5 years, like the neighboring native chordae, and there was no change in the size of artificial chordae ( Kanemoto et al ., 1999 ).…”