Surgical Application for a Prolapse of the Anterior Mitral Leaflet by Replacing Artificial Chordae with Polytetrafluoroethylene Grafts

Tomita, Yukihiro; Yasui, Hirofumi; Iwai, Toshiro; Nishida, Takahiro; Tatewaki, Hideki; Morita, Shigeki; Masuda, Mitsuharu; Yasutsune, Toru; Nishimura, Yuichi

doi:10.1007/s00595-005-3043-2

Cited by 8 publications

(3 citation statements)

References 27 publications

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“…[ 1 2 ] Since chordal replacement with PTFE suture was introduced, it has been widely adopted and the outcomes are satisfactory. [ 3 4 5 6 7 18 ] However, there are still two major problems affecting the results of artificial chordal technique for treating MR. One is adjusting the accurate length of artificial chordate, and the other is tying the knot at the intended length. At present, several techniques have been described to overcome these two problems.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Outcomes of Modified Artificial Chordae Technique for Mitral Regurgitation through Right Minithoracotomy or Median Sternotomy

Jiang

Feng

et al. 2016

Chinese Medical Journal

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Background:Right minithoracotomy (RM) has been proven to be a safe and effective approach for mitral valve surgery, but the differences of artificial chordae technique between RM and median sternotomy (MS) were seldom reported. Here, we compared the outcomes of modified artificial chordae technique for mitral regurgitation (MR) through RM or MS approaches.Methods:One hundred and eighteen consecutive adult patients who received mitral valve repair with artificial chordae and annuloplasty for MR through RM (n = 58) or MS (n = 60) from January 2006 to January 2015 were analyzed.Results:All of the selected patients underwent mitral valve repair successfully without any complication during the surgery. There was no significant difference between RM group and MS group in cardiopulmonary bypass time, aortic cross-clamp time, and early postoperative complications. However, compared with the MS group, the RM group had shorter hospital stay and faster surgical recovery. At a mean follow-up of 44.8 ± 25.0 months, the freedom from more than moderate MR was 93.9% ± 3.5% in RM group and 94.8% ± 2.9% in MS group at 3 years postoperatively. Log-rank test showed that there was no significant difference in the freedom from recurrent significant MR between the two groups (χ2 = 0.247, P = 0.619). Multivariate analysis revealed that the presence of mild MR at discharge was the independent risk factor for the recurrent significant MR.Conclusion:Right minithoracotomy can achieve the similar therapeutic effects with MS for the patients who received modified artificial chordae technique for treating MR.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Outcomes of Modified Artificial Chordae Technique for Mitral Regurgitation through Right Minithoracotomy or Median Sternotomy

Jiang

Feng

et al. 2016

Chinese Medical Journal

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“…When the prolapsed portion became wide, another PTFE suture was placed in the same fashion. At the end Kay's suture annuloplasty (n = 24) or ring annuloplasty [11] was performed.…”

Section: Technique Detailsmentioning

confidence: 99%

Different ways to repair the mitral valve with artificial chordae: a systematic review

Bizzarri

Tudisco

Ricci

et al. 2010

J Cardiothorac Surg

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Myxomatous mitral regurgitation (type II Carpentier's functional classification) affects about 1-2% of the population. This represents a very common indication for valve surgery resulting in a low percentage of repairs compared to replacement which is actually performed. In the last decades, several methods for mitral valve repair have been developed, to make the surgical feasibility easier, improve the long-term follow-up thus avoiding the need for reoperations. A very interesting method is represented by the combination of various valve repair techniques, depending on the involvement of the anterior, posterior, or both leaflets, and the use of PTFE artificial chordae tendineae when excessive chordal elongation or rupture due to myxomatous degeneration co-exists. The aim of this review is to summarize the evolution of these techniques from the beginning till now.

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“…The use of polymer to produce flexible leaflet valve has long been a focus of research since 1950s [2]. As a polymer, the ePTFE membranes were firstly reported as a valve material in an animal trail [3], and thereafter have been applied as pulmonary valve for pediatric patients [4], chordae tendineae for mitral valve repair [5,6] and heart valves in right ventricular outflow tract reconstruction (RVOT) operations [7,8]. The benefit of using ePTFE is that it provides a better modulus match than most continuous polymers for many soft biological tissue application [9], easier availability, higher biocompatible and resistance to degeneration or calcification [4].…”

Section: Introductionmentioning

confidence: 99%

Thermal treatment of expanded polytetraflu-oroethylene (ePTFE) membranes for reconstruction of a valved conduit1

Zhu

Yuan

Yeo

et al. 2015

BME

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Abstract. The unique micro porous structure of expanded polytetrafluoroethylene (ePTFE) that allows bio-integration for fixation, as well as overall mechanical integrity make it used successfully in a number of biomedical and clinical applications, which include the reconstruction of the pulmonary valve in in right ventricular outflow tract reconstruction (RVOT) operations. The objective of this study was to determine the effects of the thermal treatment on physical and mechanical properties of ePTFE membranes. ePTFE sheets were cut into 16 rectangle strips (10 mm by 60 mm) and evenly separated into 4 groups. One group was the blank control (group A), while the rest of the three groups (group B to D) were heated to 350°C and cooled to 24°C at different cooling rates (10°C/min, 20°C/min and rapid ambient air cooling) in a temperature controlled atmosphere. The mechanical and morphological characteristics of all the samples were tested using a tensile test machine and a scanning electron microscopy (SEM). The results show that the elastic modulus of group B to D was 24.95%, 33.45% and 72.76% higher than group A. The percentage elongation of groups B to D was found to be between 2.3% and 40.45 % lower than group A. The proportion of pores in the ePTFE membrane was reduced following the thermal treatment. There were no morphology differences observed between groups B to D. In summary, the selection of cooling rate was important for preserving the mechanical properties of ePTFE membranes under thermal treatment. These findings may provide useful information for the preparation of molded ePTFE valve in RVOT operations.

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Surgical Application for a Prolapse of the Anterior Mitral Leaflet by Replacing Artificial Chordae with Polytetrafluoroethylene Grafts

Cited by 8 publications

References 27 publications

Comparison of the Outcomes of Modified Artificial Chordae Technique for Mitral Regurgitation through Right Minithoracotomy or Median Sternotomy

Comparison of the Outcomes of Modified Artificial Chordae Technique for Mitral Regurgitation through Right Minithoracotomy or Median Sternotomy

Different ways to repair the mitral valve with artificial chordae: a systematic review

Thermal treatment of expanded polytetraflu-oroethylene (ePTFE) membranes for reconstruction of a valved conduit1

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