Extensive use of polytetrafluoroethylene artificial grafts for prolapse of posterior mitral leaflet

Yukihiro Tomita, Hisataka Yasui, Toshiro Iwai, Takahiro Nishida, Shigeki Morita, Munetaka Masuda, Tetsuro Sano, Yosuke Nishimura, Hideki Tatewaki

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background There are an increasing number of reports concerning mitral valve repair by means of reconstruction of the chordae tendinae with expanded polytetrafluoroethylene (e-PTFE) sutures. However little information is available about extended application or results of this technique for extended prolapse of posterior mitral leaflets. Methods Between March 1994 and December 2000, 22 patients with moderate-to-severe mitral regurgitation (MR) as the result of a prolapse of posterior leaflets (age range, 39-73 years) underwent mitral valve repair by means of reconstruction of artificial chordae with 4-CV e-PTFE sutures without leaflet resection. Either Kay's suture or ring annuloplasty was also performed to correct annular dilatation in all patients. Results No operative death or late mortality was observed. Before discharge immediate postoperative echocardiography indicated less than moderate MR in 20 out of 22 patients. The follow-up was complete in all cases by clinical examination and serial echocardiograms and the median follow-up period was 87 months (range 24-108). There were two failures that required reoperation because of unsuccessful repair and worsening MR (elongation of the anchored side of the papillary muscle). When the reoperated patients were excluded from the follow-up data, the degree of MR, estimated by echocardiography that was performed at a recent follow-up period, was nonexistent in 6 patients, trivial in 10 patients, and mild in 4 patients. The systolic and diastolic dimensions of the left ventricle decreased significantly (p < 0.01). Conclusions Replacement of the artificial chordae was not complicated and seemed to preserve favorable relationships among leaflet tissues, chordae, and papillary muscles. We therefore suggest that the extensive use of PTFE artificial chordae seems to be a promising procedure regarding the repair of many kinds of mitral lesions causing MR.

Original languageEnglish
Pages (from-to)815-819
Number of pages5
JournalAnnals of Thoracic Surgery
Volume78
Issue number3
DOIs
Publication statusPublished - Sep 1 2004

Fingerprint

Prolapse
Polytetrafluoroethylene
Mitral Valve Insufficiency
Transplants
Sutures
Papillary Muscles
Mitral Valve
Echocardiography
Reoperation
Heart Ventricles
Dilatation
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Extensive use of polytetrafluoroethylene artificial grafts for prolapse of posterior mitral leaflet. / Tomita, Yukihiro; Yasui, Hisataka; Iwai, Toshiro; Nishida, Takahiro; Morita, Shigeki; Masuda, Munetaka; Sano, Tetsuro; Nishimura, Yosuke; Tatewaki, Hideki.

In: Annals of Thoracic Surgery, Vol. 78, No. 3, 01.09.2004, p. 815-819.

Research output: Contribution to journalArticle

Tomita, Y, Yasui, H, Iwai, T, Nishida, T, Morita, S, Masuda, M, Sano, T, Nishimura, Y & Tatewaki, H 2004, 'Extensive use of polytetrafluoroethylene artificial grafts for prolapse of posterior mitral leaflet', Annals of Thoracic Surgery, vol. 78, no. 3, pp. 815-819. https://doi.org/10.1016/j.athoracsur.2004.03.036
Tomita, Yukihiro ; Yasui, Hisataka ; Iwai, Toshiro ; Nishida, Takahiro ; Morita, Shigeki ; Masuda, Munetaka ; Sano, Tetsuro ; Nishimura, Yosuke ; Tatewaki, Hideki. / Extensive use of polytetrafluoroethylene artificial grafts for prolapse of posterior mitral leaflet. In: Annals of Thoracic Surgery. 2004 ; Vol. 78, No. 3. pp. 815-819.
@article{992ab2630f0a411aab405904661d6bac,
title = "Extensive use of polytetrafluoroethylene artificial grafts for prolapse of posterior mitral leaflet",
abstract = "Background There are an increasing number of reports concerning mitral valve repair by means of reconstruction of the chordae tendinae with expanded polytetrafluoroethylene (e-PTFE) sutures. However little information is available about extended application or results of this technique for extended prolapse of posterior mitral leaflets. Methods Between March 1994 and December 2000, 22 patients with moderate-to-severe mitral regurgitation (MR) as the result of a prolapse of posterior leaflets (age range, 39-73 years) underwent mitral valve repair by means of reconstruction of artificial chordae with 4-CV e-PTFE sutures without leaflet resection. Either Kay's suture or ring annuloplasty was also performed to correct annular dilatation in all patients. Results No operative death or late mortality was observed. Before discharge immediate postoperative echocardiography indicated less than moderate MR in 20 out of 22 patients. The follow-up was complete in all cases by clinical examination and serial echocardiograms and the median follow-up period was 87 months (range 24-108). There were two failures that required reoperation because of unsuccessful repair and worsening MR (elongation of the anchored side of the papillary muscle). When the reoperated patients were excluded from the follow-up data, the degree of MR, estimated by echocardiography that was performed at a recent follow-up period, was nonexistent in 6 patients, trivial in 10 patients, and mild in 4 patients. The systolic and diastolic dimensions of the left ventricle decreased significantly (p < 0.01). Conclusions Replacement of the artificial chordae was not complicated and seemed to preserve favorable relationships among leaflet tissues, chordae, and papillary muscles. We therefore suggest that the extensive use of PTFE artificial chordae seems to be a promising procedure regarding the repair of many kinds of mitral lesions causing MR.",
author = "Yukihiro Tomita and Hisataka Yasui and Toshiro Iwai and Takahiro Nishida and Shigeki Morita and Munetaka Masuda and Tetsuro Sano and Yosuke Nishimura and Hideki Tatewaki",
year = "2004",
month = "9",
day = "1",
doi = "10.1016/j.athoracsur.2004.03.036",
language = "English",
volume = "78",
pages = "815--819",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Extensive use of polytetrafluoroethylene artificial grafts for prolapse of posterior mitral leaflet

AU - Tomita, Yukihiro

AU - Yasui, Hisataka

AU - Iwai, Toshiro

AU - Nishida, Takahiro

AU - Morita, Shigeki

AU - Masuda, Munetaka

AU - Sano, Tetsuro

AU - Nishimura, Yosuke

AU - Tatewaki, Hideki

PY - 2004/9/1

Y1 - 2004/9/1

N2 - Background There are an increasing number of reports concerning mitral valve repair by means of reconstruction of the chordae tendinae with expanded polytetrafluoroethylene (e-PTFE) sutures. However little information is available about extended application or results of this technique for extended prolapse of posterior mitral leaflets. Methods Between March 1994 and December 2000, 22 patients with moderate-to-severe mitral regurgitation (MR) as the result of a prolapse of posterior leaflets (age range, 39-73 years) underwent mitral valve repair by means of reconstruction of artificial chordae with 4-CV e-PTFE sutures without leaflet resection. Either Kay's suture or ring annuloplasty was also performed to correct annular dilatation in all patients. Results No operative death or late mortality was observed. Before discharge immediate postoperative echocardiography indicated less than moderate MR in 20 out of 22 patients. The follow-up was complete in all cases by clinical examination and serial echocardiograms and the median follow-up period was 87 months (range 24-108). There were two failures that required reoperation because of unsuccessful repair and worsening MR (elongation of the anchored side of the papillary muscle). When the reoperated patients were excluded from the follow-up data, the degree of MR, estimated by echocardiography that was performed at a recent follow-up period, was nonexistent in 6 patients, trivial in 10 patients, and mild in 4 patients. The systolic and diastolic dimensions of the left ventricle decreased significantly (p < 0.01). Conclusions Replacement of the artificial chordae was not complicated and seemed to preserve favorable relationships among leaflet tissues, chordae, and papillary muscles. We therefore suggest that the extensive use of PTFE artificial chordae seems to be a promising procedure regarding the repair of many kinds of mitral lesions causing MR.

AB - Background There are an increasing number of reports concerning mitral valve repair by means of reconstruction of the chordae tendinae with expanded polytetrafluoroethylene (e-PTFE) sutures. However little information is available about extended application or results of this technique for extended prolapse of posterior mitral leaflets. Methods Between March 1994 and December 2000, 22 patients with moderate-to-severe mitral regurgitation (MR) as the result of a prolapse of posterior leaflets (age range, 39-73 years) underwent mitral valve repair by means of reconstruction of artificial chordae with 4-CV e-PTFE sutures without leaflet resection. Either Kay's suture or ring annuloplasty was also performed to correct annular dilatation in all patients. Results No operative death or late mortality was observed. Before discharge immediate postoperative echocardiography indicated less than moderate MR in 20 out of 22 patients. The follow-up was complete in all cases by clinical examination and serial echocardiograms and the median follow-up period was 87 months (range 24-108). There were two failures that required reoperation because of unsuccessful repair and worsening MR (elongation of the anchored side of the papillary muscle). When the reoperated patients were excluded from the follow-up data, the degree of MR, estimated by echocardiography that was performed at a recent follow-up period, was nonexistent in 6 patients, trivial in 10 patients, and mild in 4 patients. The systolic and diastolic dimensions of the left ventricle decreased significantly (p < 0.01). Conclusions Replacement of the artificial chordae was not complicated and seemed to preserve favorable relationships among leaflet tissues, chordae, and papillary muscles. We therefore suggest that the extensive use of PTFE artificial chordae seems to be a promising procedure regarding the repair of many kinds of mitral lesions causing MR.

UR - http://www.scopus.com/inward/record.url?scp=4444367208&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4444367208&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2004.03.036

DO - 10.1016/j.athoracsur.2004.03.036

M3 - Article

VL - 78

SP - 815

EP - 819

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -