Background Chordae reconstruction is one of the key points in repair of mitral valve prolapse, especially for anterior leaflets. Here we introduce our experiences of using echo-determined normal chordael length to mak...Background Chordae reconstruction is one of the key points in repair of mitral valve prolapse, especially for anterior leaflets. Here we introduce our experiences of using echo-determined normal chordael length to make the loops preoperatively and rebuild the elongated/ruptured chordae intraoperatively. Materials and method From June 2011 to February 2012, 19 consecutive cases with mitral anterior leaflet prolapse underwent valve repair procedures. Echocardiography was used to determine the length of normal chordae that the prolapsed leaflets should have for normal coaptation. The artificial chordae was fabricated in loops according to echo-determined length. Results All patients survived the operations. 2.8 preoperatively prepared loops were used per patient to restore the anterior leaflets, as well as posterior leaflets. Artificial mitral valve rings were applied to 18 patients for mitral annuloplasty. 16 patients were underwent different concomitant operations. Echocardiographic results at discharge showed that grade of mitral regurgitation, left ventricular end-diastolic, end-systolic dimension de-creased definitely,respectively from 3.26 ± 1.10, 53.79 ± 15.03 mm, 33.00 ± 12.05 mm preoperatively to 0.47 ± 0.61 （P 〈 0.01）, 44.74±10.28 mm （P 〈 0.01）, 30.16 ± 10.58 mm （P 〈 0.05） postoperatively. All patients improved clinically and NYHA functional class Conclusion Reconstruction of prolapsed anterior decreased significantly from 2.17 ± 0.81 to 1.12 ± 0.33. leaflet chordae with artificial loops in preoperatively echo-de-termined length is safe and effective, and initial clinical outcome is satisfactory.展开更多
基金supported by the Natural Science Foundation of Guangdong Province, China (Grant No.S2011010005828)
文摘Background Chordae reconstruction is one of the key points in repair of mitral valve prolapse, especially for anterior leaflets. Here we introduce our experiences of using echo-determined normal chordael length to make the loops preoperatively and rebuild the elongated/ruptured chordae intraoperatively. Materials and method From June 2011 to February 2012, 19 consecutive cases with mitral anterior leaflet prolapse underwent valve repair procedures. Echocardiography was used to determine the length of normal chordae that the prolapsed leaflets should have for normal coaptation. The artificial chordae was fabricated in loops according to echo-determined length. Results All patients survived the operations. 2.8 preoperatively prepared loops were used per patient to restore the anterior leaflets, as well as posterior leaflets. Artificial mitral valve rings were applied to 18 patients for mitral annuloplasty. 16 patients were underwent different concomitant operations. Echocardiographic results at discharge showed that grade of mitral regurgitation, left ventricular end-diastolic, end-systolic dimension de-creased definitely,respectively from 3.26 ± 1.10, 53.79 ± 15.03 mm, 33.00 ± 12.05 mm preoperatively to 0.47 ± 0.61 （P 〈 0.01）, 44.74±10.28 mm （P 〈 0.01）, 30.16 ± 10.58 mm （P 〈 0.05） postoperatively. All patients improved clinically and NYHA functional class Conclusion Reconstruction of prolapsed anterior decreased significantly from 2.17 ± 0.81 to 1.12 ± 0.33. leaflet chordae with artificial loops in preoperatively echo-de-termined length is safe and effective, and initial clinical outcome is satisfactory.
