HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Loris Salvador Salvatore Mirone Roberto Bianchini Tommaso Regesta Giuseppe Minniti Carlo Valfrè Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Salvador, L. Articles by Valfrè, C. Search for Related Content PubMed Articles by Salvador, L. Articles by Valfrè, C. Related Collections Valve disease Related Article

J Thorac Cardiovasc Surg 2008;135:1280-1287
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

A 20-year experience with mitral valve repair with artificial chordae in 608 patients

Division of Cardiac Surgery of Santa Maria dei Battuti Hospital, Treviso, Italy

Received for publication June 23, 2007; revisions received December 20, 2007; accepted for publication December 27, 2007.

^_* Address for reprints: Loris Salvador, MD, FECTS, Department of Cardiac Surgery, Santa Maria dei Battuti Hospital, Piazza Ospedale 1, 31100 Treviso, Italy. (Email: medloris{at}yahoo.it).

Objective: Mitral valve repair with artificial chordae for degenerative mitral regurgitation is widely adopted. We evaluated long-term results of mitral repair with expanded polytetrafluoroethylene sutures (GORE-TEX CV-5; W. L. Gore & Associates, Inc, Flagstaff, Ariz).

Methods: Between November 1986 and November 2006, 608 consecutive patients underwent mitral repair with artificial neochordae. Mean age was 55 ± 11 years (15–85 years); 433 (71.2%) were male. Valve disease was purely degenerative in 555 patients (91.3%). Prolapse of anterior, posterior, or both leaflets was present in 47 (7.7%), 308 (50.7%), and 253 (41.6%), respectively. Atrial fibrillation was associated in 117 (19.2%). In 125 cases (20.5%), additional surgical procedures were performed. Follow-up was complete at a median of 5.7 years (interquartile range 2.2–9.8 years, range 0–19.4 years).

Results: In-hospital mortality was less than 1% (6 deaths). Overall and cardiac late mortalities were 6.6% and 3.9% (34 and 24 deaths). Kaplan–Meier survival at 15 years was 84% (95% confidence interval 75%–90%). Freedoms from endocarditis, thromboembolic events, reoperation, and recurrent mitral regurgitation at 15 years were 97% (95% confidence interval 93%–99%), 92% (87%–95%), 92% (88%–95%), and 85% (78%–91%), respectively. Sinus rhythm was restored in 75% (33 patients) after surgical atrial fibrillation correction. Calcification of GORE-TEX neochordae was never reported.

Conclusion: Mitral valve repair with GORE-TEX artificial chordae is effective, safe, and associated with low operative mortality and low rates of valve-related complications at long-term follow-up. Artificial chordae showed excellent biologic adaptation, retaining flexibility and tension with time.

Related Article

Discussion
J. Thorac. Cardiovasc. Surg. 2008 135: 1287. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				G. Panic, M. Ristic, S. Putnik, D. Markovic, I. Divac, and U. U. Babic A novel technique for treatment of mitral valve prolapse/flail. J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1568 - 1570. [Full Text] [PDF]

				T. Fannelop, G. O. Dahle, P.-R. Salminen, C. A. Moen, K. Matre, A. Mongstad, F. Eliassen, L. Segadal, and K. Grong Multidose Cold Oxygenated Blood Is Superior to a Single Dose of Bretschneider HTK-Cardioplegia in the Pig Ann. Thorac. Surg., April 1, 2009; 87(4): 1205 - 1213. [Abstract] [Full Text] [PDF]