Midterm results of mitral valve repair with artificial chordae in children Kazu Minami, MD, Hideaki Kado, MD, Sadahiro Sai, MD, Hideki Tatewaki, MD, Yuichi.

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Presentation transcript:

Midterm results of mitral valve repair with artificial chordae in children Kazu Minami, MD, Hideaki Kado, MD, Sadahiro Sai, MD, Hideki Tatewaki, MD, Yuichi Shiokawa, MD, Atsuhiro Nakashima, MD, Koji Fukae, MD, Hitoshi Hirose, MD, FACS The Journal of Thoracic and Cardiovascular Surgery Volume 129, Issue 2, Pages 336-342 (February 2005) DOI: 10.1016/j.jtcvs.2004.10.016 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Surgical method of MV repair. A, A double-armed ePTFE suture was passed through the rough zone of the prolapsed leaflet and through the papillary muscle at 3 to 4 mm from its top. The sutures were then passed through a pledget on the side of the muscle, where the sutures emerged from the papillary muscle. B, This suture was drawn until the leaflet was drawn to the papillary muscle. The knot was then tied a little longer than at the level of the opposing normal leaflet. C, The new chordae were then pulled back through the papillary muscle until the pledget came up against the muscle. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 336-342DOI: (10.1016/j.jtcvs.2004.10.016) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Postoperative echocardiography in 4-chamber view at the end-systolic phase. MV diameter, Diameter of the mitral annulus; AP distance, distance between the mitral annulus and the top of the papillary muscle. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 336-342DOI: (10.1016/j.jtcvs.2004.10.016) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Comparison of preoperative and postoperative MR. One patient underwent MV replacement after the operation, and 2 additional patients underwent redo MV repair in a late follow-up period. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 336-342DOI: (10.1016/j.jtcvs.2004.10.016) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Actuarial freedom from reoperation after MV repair with ePTFE sutures. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 336-342DOI: (10.1016/j.jtcvs.2004.10.016) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Ratio of the diameter of the mitral annulus to the distance between the plane of the mitral annulus and the top of the papillary muscle, as measured by means of echocardiography (MV diameter/AP distance). The Journal of Thoracic and Cardiovascular Surgery 2005 129, 336-342DOI: (10.1016/j.jtcvs.2004.10.016) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Changes of the ratio of MV diameter to AP distance between postoperative and late follow-up in 16 patients whose body surface areas were increased more than 1.5 times. AP distance, The distance between the plane of the mitral annulus and the top of the papillary muscle; MV diameter, the diameter of the mitral annulus. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 336-342DOI: (10.1016/j.jtcvs.2004.10.016) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions