title: Extensive use of polytetrafluoroethylene artificial grafts for prolapse of bilateral mitral leaflets.
abstract: OBJECTIVE
  There are an increasing number of reports concerning mitral valve repair by reconstruction of the chordae tendinae with the use of expanded polytetrafluoroethylene (PTFE) sutures. However, little information is available about the extended application or results of this technique for extended prolapse of bilateral mitral leaflets, which is considered to be difficult to repair.
  
  
  METHODS
  Between October 1993 and May 1998, 17 patients (age range 16-74 years) who had from moderate to severe mitral regurgitation as the result of a prolapse of bilateral leaflets underwent mitral valve repair by reconstruction of artificial chordae with CV-4 expanded PTFE sutures. Either bilateral or unilateral Kay's suture annuloplasty was also performed to correct annular dilatation in all patients.
  
  
  RESULTS
  No operative death or late mortality was observed. Before discharge, immediate postoperative echocardiography showed less than moderate mitral regurgitation in 16 of 17 patients. The follow-up was completed in all cases by a clinical examination and serial echocardiograms, and the median follow-up period was 52 months (range 27-82 months). There was one failure that required re-operation because of worsening mitral regurgitation (elongation of the anchored side of papillary muscle). When the re-operated patient was excluded from the following data, the degree of mitral regurgitation, estimated by echocardiography performed at recent follow-up, was none in four patients, trivial in eight patients, and mild in four patients. The systolic and diastolic dimensions of the left ventricle decreased significantly (P<0.01).
  
  
  CONCLUSIONS
  Because replacement of artificial chordae was not complicated and seemed to preserve fine relationships among leaflet tissues, chordae, and papillary muscles, we therefore suggest that the extensive use of PTFE artificial chordae appears to be a promising procedure for the repair of all kinds of mitral lesions causing mitral regurgitation.
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. tomita@heart.med.kyushu-u.ac.jp
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Tomita
authors.forename: Hisataka
authors.initials: H
authors.lastname: Yasui
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tominaga
authors.forename: Shigeki
authors.initials: S
authors.lastname: Morita
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kurisu
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nishimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002815:Chordae Tendineae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000628:therapy*; D011138:Polytetrafluoroethylene; D013537:Sutures
chemical_list: D011138:Polytetrafluoroethylene