title: Echocardiographic evaluation of patients submitted to replacement of ruptured chordae tendineae.
abstract: OBJECTIVE
  The objective of this study was to evaluate, using echocardiography, the functioning of the mitral valve apparatus in patients submitted to standardized bovine pericardium chordae implantation to substitute ruptured chordae tendineae or elongated chordae with a significant degree of thinning.
  
  
  METHODS
  Standardized bovine pericardium chordae were implanted in 23 patients with mitral valve insufficiency due to ruptured or elongated chordae with significant thinning. The ages of the patients varied from 23 to 84 years old (mean 62 years old). The most common cause was fibroelastic degeneration affecting 20 (87.0%) patients. The standardized bovine pericardium chordae were manufactured in sets connected at both ends by two polyester-reinforced rods thereby forming a single block. The bovine pericardium chordae measure 2 mm wide with 3 mm between the chordae. The sets of bovine pericardium chordae are produced in lengths varying from 20 to 35 mm. In 17 (73.9%) patients bovine pericardium chordae were implanted in the posterior cusp and in 6 (26.1%) in the anterior cusp. All the patients were evaluated in the postoperative period by echocardiography after a mean follow-up of six months.
  
  
  RESULTS
  The echocardiography in the postoperative period demonstrated an absence of reflux in 11 (47.8%) patients, slight reflux in 8 (34.8%) and slight to moderate reflux in 3 (13.0%). The opening and mobility of the mitral valve was normal in the 22 surviving patients.
  
  
  CONCLUSIONS
  The echocardiography demonstrated good functioning of the mitral valve apparatus in patients submitted to the implantation of standardized bovine pericardium chordae to substitute ruptured chordae tendineae or elongated chordae with a significant degree of thinning.
authors.affiliation: Medicine School in São José do Rio Preto - FAMERP. joaocarlos@braile.com.br
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Leal
authors.forename: Francisco
authors.initials: F
authors.lastname: Gregori
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Galina
authors.forename: Rubens S
authors.initials: RS
authors.lastname: Thevenard
authors.forename: Domingo Marcolino
authors.initials: DM
authors.lastname: Braile
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001705:Bioprosthesis; D002417:Cattle; D002815:Chordae Tendineae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006341:Heart Rupture / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000592:standards; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D010496:Pericardium / Q000637:transplantation*; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler