title: [Long-term outcome of repair of prolapsing anterior mitral leaflet with artificial chordae replacement].
abstract: OBJECTIVE
  We have performed a simple and uniform technique for reconstruction of artificial chordae in patients with anterior mitral prolapse since 1994. In this study, we investigated the long-term clinical and echocardiographic results of chordae replacement with Gore-Tex sutures for anterior mitral leaflet prolapse.
  
  
  METHODS
  A pair of Gore-Tex sutures is passed through a small autologous pericardium and tied on one side of the pericardium. Double-armed mattress stitches on the side without a knot are passed through the head of the papillary muscle and another small pericardium and then tied down. Using this simple technique, 2 pairs of artificial chordae are made. The length of the artificial chordae is determined during the leak test. Chordal replacement with this technique was performed in 30 patients (mean age, 59.3 years) with anterior mitral leaflet prolapse. Echocardiography was performed annually in these patients. Follow-up ranged from 0.2~16.2( 8.0±5.1) years.
  
  
  RESULTS
  There were no hospital deaths. Twenty-one patients had no mitral regurgitation( MR) and the others had trivial or mild MR. There were 2 reoperations and 4 cases with recurrent moderate MR in this series. Kaplan-Meier survival and freedom from reoperation at 15 years were 84% and 93%,respectively. Overall, freedom from recurrent moderate or severe MR at 15 years was 81%.
  
  
  CONCLUSIONS
  Our simple chordae replacement technique with Gore-Tex sutures for anterior mitral prolapse, results in good long-term durability. To avoid recurrence of regurgitation, intraoperative complete repair is essential.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Saga University, Saga, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Furukawa
authors.forename: Keiji
authors.initials: K
authors.lastname: Kamohara
authors.forename: Manabu
authors.initials: M
authors.lastname: Itoh
authors.forename: Akira
authors.initials: A
authors.lastname: Furutachi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morokuma
authors.forename: Shigeki
authors.initials: S
authors.lastname: Morita
mesh_terms: D000328:Adult; D000368:Aged; D002815:Chordae Tendineae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000601:surgery*; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene