The “Loop with Anchor” Technique to Repair Mitral Valve Prolapse

Isoda, Susumu; Osako, Motohiko; Kimura, Tamizo; Mashiko, Yuji; Yamanaka, Nozomu; Nakamura, Shingo; Maehara, Tadaaki

doi:10.5761/atcs.nm.11.01705

Cited by 3 publications

(2 citation statements)

References 4 publications

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“… 22 The Leipzig group 25 recently published the results of their technique, with a 10‐year freedom from reoperation of 97 ± 1%. A number of modifications to the standard loop technique have been proposed over the years 26 , 27 : the use of small anchors to facilitate eventual length adjustment after hydrostatic testing, 26 or the use of small pieces of paper as wide as the desired length of the loop, which are tightened around it. 27 …”

Section: Artificial Chords Step‐by‐stepmentioning

confidence: 99%

Mitral valve repair with artificial chords: Tips and tricks

Mauro

Bonalumi

Giambuzzi

et al. 2022

Journal of Cardiac Surgery

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Mitral valve regurgitation (MR) is a common valvular disorder occurring in up to 10% of the general population. Mitral valve reconstructive strategies may address any of the components, annulus, leaflets, and chords, involved in the valvular competence. The classical repair technique involves the resection of the prolapsing tissue. Chordal replacement was introduced already in the '60, but in the mid '80, some surgeons started to use expanded polytetrafluoroethylene (ePTFE) Gore‐Tex sutures. In the last years, artificial chords have been used also using transcatheter approach such as NeoChord DS 1000 (Neochord) and Harpoon TSD‐5. The first step is to achieve a good exposure of the papillary muscles that before approaching the implant of the artificial chords. Then, the chords are attached to the papillary muscle, with or without the use of supportive pledgets. The techniques to correctly implant artificial chords are many and might vary considerably from one center to another, but they can be summarized into three big families of suturing techniques: single, running or loop. Regardless of how to anchor to the mitral leaflet, the real challenge that many surgeons have taken on, giving rise to some very creative solutions, has been to establish an adequate length of the chords. It can be established based on anatomically healthy chords, but it is important to bear in mind that surgeons work on the mitral valve when the heart is arrested in diastole, so this length could fail to replicate the required length in the full, beating heart. Hence, some surgeons suggested techniques to overcome this problem. Herein, we aimed to describe the current use of artificial chords in real‐world surgery, summarizing all the tips and tricks.

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Section: Artificial Chords Step‐by‐stepmentioning

confidence: 99%

Mitral valve repair with artificial chords: Tips and tricks

Mauro

Bonalumi

Giambuzzi

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

show abstract

“…The Leipzig group 26 recently published the results of their technique with a freedom from re-operation at 10 years up to 97 +-1%. Some modifications of the standard loop technique have been proposed over the years 27.28 ; the use of small anchors to make easier eventual length adjustment after the hydrostatic test 27 , or the use of small pieces of paper as wide as the desired length of the loop, which is tight around it 28 .…”

Section: Exposure Of the Papillary Musclesmentioning

confidence: 99%

Mitral Valve Repair with Artificial Chords: Tips & Tricks

Mauro

Bonalumi

Giambuzzi

et al. 2022

Preprint

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Mitral valve regurgitation (MR) is a common valvular disorder occurring in up to 10% of the general population. Mitral valve reconstructive strategies may address any of the components, annulus, leaflets and chords, involved in the valvular competence. The classical repair technique involves the resection of the prolapsing tissue. Chordal replacement was introduced already in the ’60, but in the mid ’80, some surgeons started to use expanded polytetrafluoroethylene (ePTFE) Gore-Tex sutures. In the last years, artificial chords have been exploited because of transcatheter techniques such as NeoChord DS 1000 (Neochord, USA) and Harpoon TSD-5. The first step is to achieve a good exposure of the papillary muscles that before approaching the implant of the artificial chords. Then, the chords are attached to the papillary muscle, with or without the use of supportive pledgets. The techniques to correctly implant artificial chords are many and might vary considerably from one center to another, but they can be summarized into three big families of suturing techniques: single, running or loop. Regardless of how to anchor to the mitral leaflet, the real challenge that many surgeons have taken on, giving rise to some very creative solutions, has been to establish an adequate length of the chords. It can be established basing on anatomically healthy chords, but it is important to bear in mind that surgeons work on the mitral valve when the heart is arrested in diastole, so this length could fail to replicate the required length in the full, beating heart. Hence, some surgeons suggested techniques to overcome this problem. Herein, we aimed to describe the current use of artificial chords in real world surgery, summarizing all the tips and tricks.

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Artificial chordae for degenerative mitral valve disease: critical analysis of current techniques

Ibrahim

Rao

Athanasiou

2012

Interactive CardioVascular and Thoracic Surgery

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The surgical repair of degenerative mitral valve disease involves a number of technical points of importance. The use of artificial chordae for the repair of degenerative disease has increased as a part of the move from mitral valve replacement to repair of the mitral valve. The use of artificial chordae provides an alternative to the techniques pioneered by Carpentier (including the quadrangular resection, transfer of native chordae and papillary muscle shortening/plasty), which can be more technically difficult. Despite a growth in their uptake and the indications for their use, a number of challenges remain for the use of artificial chordae in mitral valve repair, particularly in the determination of the correct length to ensure optimal leaflet coaptation. Here, we analyse over 40 techniques described for artificial chordae mitral valve repair in the setting of degenerative disease.

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The “Loop with Anchor” Technique to Repair Mitral Valve Prolapse

Cited by 3 publications

References 4 publications

Mitral valve repair with artificial chords: Tips and tricks

Mitral valve repair with artificial chords: Tips and tricks

Mitral Valve Repair with Artificial Chords: Tips & Tricks

Artificial chordae for degenerative mitral valve disease: critical analysis of current techniques

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