Affordable Access

Publisher Website

1019-29 Resection vs PTFE Chordal Replacement for Repair of Mitral Valve Insufficiency

Authors
Journal
Journal of the American College of Cardiology
0735-1097
Publisher
Elsevier
Publication Date
Volume
25
Issue
2
Identifiers
DOI: 10.1016/0735-1097(95)93101-h

Abstract

Traditional management of prolapsing leaflets involves leaflet resection ± native chordal repair. Uncertainty exists as to the role of chordal replacement with PTFE sutures. We compared the outcome of repair in 108 pts, 56 (52%) with #5 PTFE chordae (C) and 52 (48%) with resection (R). Both C & R had Puig-Massana ring annuloplasties. Mean age was 61 ± 16 yrs, 53 were male (49%) and 79% of pts were NYHA III or IV. Sinus rhythm was present in 75 (69%) pts, atrial fibrillation in 25 (23%). Etiology was myxomatous: 68 (63%). rheumatic: 13 (12%) ischemic: 12 pts (11%). Other valve replacement ± CAB were performed in C 16 (29%) pts, R 27 (52%) (p = 0.0132). Clamp time was 56 ± 23 min. for C, 61 ± 28 min for R (p = NS). bypass time 78 ± 30 and 84 ± 30 min (p = NS). Mortality (30 day) was CR 1/56 (1.8%), R 3/52 (5.8%) (p = NS). Post-op, mitral regurgitation was absent/mild in 104 (96%) pts, for CR 53 (95%), R 51 (98%) (p = NS). Predischarge mitral valve gradient was for CR, 2.45 ± 1.78 mm and RT 2.73 ± 2.45 mm (p = NS). At follow-up of up to 5 years, 96% of pts were NYHA I or II. Reoperation was required in C 1/56 (2%) R 4/52 (8%). p = NS. Thus use of C produced results similar to R. C repair can be used in all pts with mobile leaflets and mitral regurgitation, especially when both anterior and posterior leaflets are involved.

There are no comments yet on this publication. Be the first to share your thoughts.