A simple method to obtain the correct length of the artificial chordae in complex chordal replacement.
BACKGROUND
Different techniques have been proposed to measure the correct length of artificial chordae. We herein describe a new simple method to measure the chordal length in complex chordal replacement.


METHODS
Chordal replacement was used by us for two different purposes: (1) to maintain the correct chordal length for the anterior leaflet (AL) and (2) to eliminate any movement of the posterior leaflet (PL) to fix it. To reach this goal, the AL is pulled up to the maximum extent and the new chordae are tied 5 mm higher than the related border. On the contrary, in the PL the new chordae are tied at the level of the related border.


RESULTS
From March 2006 to March 2007, at the University of Catania, this technique was used in 32 patients (16 for correction of PL prolapse, 6 patients for correction of AL prolapse, and in 10 patients for correction of both leaflets prolapse). The number of chordae per patients was 8.6 for the PL and 6.8 for the AL. No patient died or had major complications. After a mean follow-up of 5 +/- 2 months, two-dimensional echocardiography showed that all the patients had no or trivial mitral regurgitation (MR). The echocardiogram showed a correct movement of the new chordae.


CONCLUSIONS
This technique allows to easily establish the length of the new chordae of the AL and, if necessary, of the PL in complex mitral valve repair.
Calafiore
Antonio M
AM
Division of Cardiac Surgery, University of Catania, Catania, Italy. calafiore@unict.it
Scandura
Salvatore
S
Iacò
Angela L
AL
Contini
Marco
M
Di Mauro
Michele
M
Bivona
Antonio
A
Giordano
Guido
G
Bosco
Paolo
P
D001672:Biocompatible Materials; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002815:Chordae Tendineae / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D010210:Papillary Muscles / Q000601:surgery; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D013536:Suture Techniques; D016896:Treatment Outcome; D014894:Weights and Measures
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene