[Repair of anterior leaflet mitral valve prolapse: the comparison between chordal replacement and chordal shortening].
OBJECTIVE
To compare the relative merits between chordal shortening and artificial chordae to repair the anterior leaflet prolapses (ALP).


METHODS
The clinic data of 50 cases underwent repair of ALP from March 1990 to March 2008 were analyzed retrospectively. There were 29 male and 21 female patients with a mean age of (42.6 +/- 11.3) years old. There were 23 patients in chordal shortening group and 27 patients in artificial chordae group.


RESULTS
There were 3 operative deaths in chordal shortening group (13.0%), and 1 death in artificial chordae group (3.7%, P = 0.199). With a mean follow-up of (5.8 +/- 4.8) years and a total follow-up of 278 patient-years, there were 3 late deaths respectively in each group. According the Kaplan-Meier survival curve, the actuarial survival rate at 5-8 years was 70.0% +/- 18.2% for chordal shortening group and 86.8% +/- 9.2% for artificial chordae group (chi(2) = 8.17, P = 0.046). There were 5 reoperations, of which 4 in chordal shortening group and 1 in artificial chordae group. According to the Kaplan-Meier freedom from reoperation curve, the freedom from reoperation at 5 years was 83.3% +/- 15.2% for chordal shortening group and 100% for artificial chordae group (chi(2) = 12.06, P = 0.007). The COX proportional hazard regressions revealed that chordal-shortening technique was the independent risk predictor for the late cardiac event after ALP surgical repair.


CONCLUSIONS
Artificial chordae techniques has a relative superiority to chordal shortening for repair of mitral valve ALP.
Gan
Hui-li
HL
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University (BAZH-CMU), Beijing Institute of Heart, Lung and Vessel Disease, Beijing 100029, China. ganhuili@hotmail.com
Zhang
Jian-qun
JQ
Wang
Sheng-xun
SX
Zhou
Qi-wen
QW
Kong
Qing-yu
QY
Zheng
Si-hong
SH
Bo
Ping
P
Huang
Guo-hui
GH
Chen
Wei
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002815:Chordae Tendineae / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome