Simplified Placement of Multiple Artificial Mitral Valve Chords

Abstract

The use of artificial chords for the replacement of diseased mitral valve chordae and the correction of anterior and posterior leaflet prolapse is well described, although it is infrequently applied because of technical challenges. A simplified approach to attaching the new chords to a single papillary muscle base within the left ventricle has been reported, and we present a series of 13 patients with moderate-severe mitral regurgitation (MR) who underwent chordal replacement using this improved technique. The MR grade by echocardiogram improved from 3.7 +/- 0.4 preoperatively to 1.0 +/- 0.8 postoperatively. All patients were doing well at a mean follow-up interval of 285 +/- 62 days. Chordal replacement for both anterior and posterior leaflet prolapse is an effective treatment for MR when combined with standard mitral valve repair techniques. The authors' technique of determining proper chordal height and placing multiple chordae is also discussed.