title: Artificial chordae for pediatric mitral and tricuspid valve repair.
abstract: OBJECTIVE
  To evaluate pediatric atrioventricular valve repair with artificial chordae.
  
  
  METHODS
  Between February 2001 and January 2006, artificial chords were used in 21 children with severe mitral or tricuspid valve regurgitation. Patients with AVSD were excluded. Median age was 84 (1-194) months. Five patients had isolated tricuspid valve anomalies, 16 had mitral valve anomalies (associated tricuspid annular dilatation in 4). Tricuspid neochordae were placed to anterior (three patients) and septal (two patients) leaflets. Mitral neochordae were placed to anterior (15 patients) and posterior (1 patient) leaflets. Additional ring annuloplasties were performed in 12 (mitral 11, tricuspid 1), as well as 2 de Vega tricuspid annuloplasties. Patch insertion was used in acute endocarditis (tricuspid one). All echocardiographic studies were reviewed and analyzed by a single cardiologist.
  
  
  RESULTS
  No mortality occurred. Follow-up was complete (mean 28+/-18 months). Two patients were reoperated, one for mitral ring dehiscence and one for recurring mitral valve insufficiency. Both valves were replaced by mechanical valve prosthesis. At last follow-up tricuspid insufficiency was mild (three) or moderate (two). Moderate insufficiency occurred due to remaining restriction of the septal leaflet after repair in endocarditis (one) and remaining prolapse of the anterior leaflet (one). Mitral insufficiency was absent (five), mild (seven), or moderate (two). Moderate insufficiency was caused by recurrent anterior leaflet shortening after valve repair in rheumatic valve disease (two). Valve restriction caused by artificial chordae was not found.
  
  
  CONCLUSIONS
  Mitral and tricuspid valve repair with artificial chordae in children demonstrated acceptable results. Despite patient growth, valvular restriction by the artificial chordae was not observed ad mid-term follow-up.
authors.affiliation: Leiden University Medical Center, Leiden, Netherlands.
authors.forename: Rody
authors.initials: R
authors.lastname: Boon
authors.forename: Mark
authors.initials: M
authors.lastname: Hazekamp
authors.forename: Gerard
authors.initials: G
authors.lastname: Hoohenkerk
authors.forename: Marry
authors.initials: M
authors.lastname: Rijlaarsdam
authors.forename: Paul
authors.initials: P
authors.lastname: Schoof
authors.forename: Dave
authors.initials: D
authors.lastname: Koolbergen
authors.forename: Lourdes
authors.initials: L
authors.lastname: Heredia
authors.forename: Robert
authors.initials: R
authors.lastname: Dion
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002815:Chordae Tendineae / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008943:Mitral Valve / Q000002:abnormalities / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011138:Polytetrafluoroethylene; D012086:Reoperation; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000002:abnormalities / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography
chemical_list: D011138:Polytetrafluoroethylene