Choice of artificial chordae length according to echocardiographic criteria.

A simple way to identify artificial chordae length is reported. The distance A between the edge of the prolapsing anterior leaflet and the plane of the mitral annulus is measured during perioperative transesophageal echocardiography. When the mitral valve is exposed, the elongated chorda, corresponding to the scallop previously evaluated, is measured with a ruler and A is subtracted. This is the length of the new chorda that is measured with a ruler and tied at that level after being properly positioned.