New surgical method of chordal replacement for mitral valve incompetence with echocardiographic guidance
| Autor: | Hiroshi Yuasa, Takatsugu Shimono, Toru Mizumoto, Katsumoto Hatanaka, Isao Yada, Hitoshi Kusagawa |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Pulmonary and Respiratory Medicine
Fibrous joint medicine.medical_specialty biology business.industry Chorda biology.organism_classification Surgery Surgical methods law.invention Mitral valve incompetence medicine.anatomical_structure Left atrial Ventricle law medicine Cardiopulmonary bypass Cardiology and Cardiovascular Medicine business Papillary muscle |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 108:719-726 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(94)70299-3 |
| Popis: | Chordal replacement with expanded polytetrafluoroethylene suture has become a procedure of choice for repairing anterior leaflet prolapse among certain surgeons. However, most surgeons believe that the chordal replacement is too complicated and not reproducible. This report introduces a new method of chordal replacement using intraoperative epicardial and transesophageal echocardiography. Three dogs underwent the following procedures. One major marginal chorda of an anterior mitral leaflet was resected during cardiopulmonary bypass. A specially designed 3-0 polytetrafluoroethylene suture, having straight needles, was attached to the anterior leaflet by a mattress suture. Then the needles were brought from the root of the anterior papillary muscle to the outside of the left ventricle. After the bypass flow was reduced, both ends of the polytetrafluoroethylene suture were pulled under echocardiographic guidance until valve competence was achieved. At that point, the suture was temporarily tied. When cardiopulmonary bypass was discontinued, competence was again confirmed and the suture was tied permanently. When the procedures were completed, echocardiography showed trivial regurgitation and good pliability of the anterior leaflets in all animals. Left atrial pressures were sufficiently decreased. It appears that this new technique is reproducible for all surgeons because the optimal length of polytetrafluoroethylene chordae is determined with the valve functioning. (J THORAC CARDIOVASC SURG 1994;108:719-26) |
| Databáze: | OpenAIRE |
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