T E David1, S Armstrong, Z Sun. 1. Division of Cardiovascular Surgery, University of Toronto, Ontario, Canada.
Abstract
BACKGROUND AND AIMS OF THE STUDY: Expanded polytetrafluoroethylene sutures have been used for the replacement of chordae tendineae of the mitral valve since 1985 at The Toronto Hospital. This study examines the long term results of mitral valve repair with chordal replacement with this material. MATERIALS AND METHODS: From July 1985 to December 1993, 134 consecutive patients with mitral regurgitation due to degenerative disease of the mitral valve underwent mitral valve repair with replacement of elongated or ruptured chordae tendineae with one to six (mean of 2.8) Gore-Tex sutures. The patients' mean age was 61 years, range 22-86. In addition to mitral valve repair, 14 patients underwent aortic valve surgery, three underwent replacement of the ascending aorta, six underwent tricuspid valve repair, nine underwent the maze procedure for atrial fibrillation, and 13 underwent coronary artery bypass. The patients were followed for between 20 and 116 months, mean 51 months. No patient has been lost to follow up. RESULTS: There were one operative and eight late deaths. The actuarial survival at eight years was 88% +/- 6%. Four patients required reoperation, one for persistent hemolysis and three for recurrent mitral regurgitation. The Gore-Tex chordae were not responsible for the reoperation in any patient. The freedom from reoperation at eight years was 96% +/- 2%. CONCLUSIONS: Expanded polytetrafluoroethylene sutures are excellent for chordal replacement during mitral valve repair and do not fail during the first decade following surgery. This material has allowed us to increase the probability of successful mitral valve repair in patients with degenerative disease of the mitral valve and prolapse of both leaflets.
BACKGROUND AND AIMS OF THE STUDY: Expanded polytetrafluoroethylene sutures have been used for the replacement of chordae tendineae of the mitral valve since 1985 at The Toronto Hospital. This study examines the long term results of mitral valve repair with chordal replacement with this material. MATERIALS AND METHODS: From July 1985 to December 1993, 134 consecutive patients with mitral regurgitation due to degenerative disease of the mitral valve underwent mitral valve repair with replacement of elongated or ruptured chordae tendineae with one to six (mean of 2.8) Gore-Tex sutures. The patients' mean age was 61 years, range 22-86. In addition to mitral valve repair, 14 patients underwent aortic valve surgery, three underwent replacement of the ascending aorta, six underwent tricuspid valve repair, nine underwent the maze procedure for atrial fibrillation, and 13 underwent coronary artery bypass. The patients were followed for between 20 and 116 months, mean 51 months. No patient has been lost to follow up. RESULTS: There were one operative and eight late deaths. The actuarial survival at eight years was 88% +/- 6%. Four patients required reoperation, one for persistent hemolysis and three for recurrent mitral regurgitation. The Gore-Tex chordae were not responsible for the reoperation in any patient. The freedom from reoperation at eight years was 96% +/- 2%. CONCLUSIONS: Expanded polytetrafluoroethylene sutures are excellent for chordal replacement during mitral valve repair and do not fail during the first decade following surgery. This material has allowed us to increase the probability of successful mitral valve repair in patients with degenerative disease of the mitral valve and prolapse of both leaflets.